Inspection on 18/02/09 for Clifford House

This inspection was carried out on 18th February 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clifford House 21/09/06

Clifford House 12/12/05

Clifford House 31/05/05

Clifford House 15/09/04

Clifford House 28/04/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Clifford House Clifford House Westlinton Carlisle Cumbria CA6 6AG     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: Diane Jinks     Date: 1 8 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Clifford House Clifford House Westlinton Carlisle Cumbria CA6 6AG 01228791514 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Oriel Graham Name of registered manager (if applicable) Mrs Oriel Graham Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The home is registered for a maximum of 5 service users to include: up to 5 service users in the category of LD ( Adults with Learning disabilities) Date of last inspection Brief description of the care home Clifford House is a modern detached property, approximately 3 miles north of Carlisle. It is based in the village of West Linton, which has a pub and cafe and is served by a regular bus service to Carlisle and Longtown. The people that live at Clifford House access day services by either taxi, or minibus provided by that service. Mrs Graham arranges taxis or uses her own car to transport people to town or to visit relatives. Private bedrooms are all above the National Minimum Standard size and all have hand wash basins installed. There is a bathroom and shower room on the first floor and a shower room and separate toilet on the ground floor. Communal space is provided by a large lounge additionally there is a large entrance hallway/lounge that has comfortable seating, a gas fire and a television. There is a large combined kitchen and dining room, Care Homes for Adults (18-65 years) Page 4 of 31 care home 5 Over 65 0 5 Brief description of the care home which also has a settee and two easy chairs. A conservatory has been added to the rear of the house. The owner provides care and accommodation to five people with a learning disability. Care Homes for Adults (18-65 years) Page 5 of 31 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: The assessment of this service took place over several weeks and included a visit to the home. As part of the assessment we sent questionnaires to the people that live at Clifford House. The owner ensured that people were supported independently of Clifford House to complete their questionnaires. We also spoke to the owner and one of the people at the home during our visit. We carried out an annual service review of this service in March 2008. From the information we received at that time we judged that this home continued to provide a good service. The manager completed an annual quality assurance assessment (AQAA) for this inspection. This document provided us with further information about the home and the services it provides. It also tells us where the owner has made improvements and Care Homes for Adults (18-65 years) Page 6 of 31 the areas she intends to make further improvements to over the next 12 months. What the care home does well: What has improved since the last inspection? What they could do better: As a result of this visit, we have made some requirements relating mainly to health and safety issues that the owner must address and some good practice recommendations for her consideration. These should not detract from the fact that people using this service generally experience good quality outcomes for their chosen lifestyles. The people that live at Clifford House do have some plans outlining their care and support needs. There is a lot of information stored in their care records. The records need to be more organised. More information about care and support needs, including Care Homes for Adults (18-65 years) Page 8 of 31 strategies for how these needs will be met must be clearly detailed and recorded in care plans. The way in which medicines are handled at the home must be reviewed. We saw some practices that potentially place people using this service at risk of receiving medication in error. The owner and a member of her staff are due to undertake further training in the administration of medication, which may help to resolve medication issues. There are some elements of risk assessment included in individual care records. These need to be improved upon to ensure that all aspects of peoples lives, care and support needs are managed safely at all times. The owner told us that there is a fire evacuation plan in place at the home, which would be used in the event of fire. However, the owner has not developed a fire risk assessment for the home and this needs to be completed without delay to help ensure that the home is safe and compliant with the law relating to fire. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 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 31 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. People using this service are provided with sufficient information to help them make their decision to move into Clifford House. Evidence: The owner of the home has produced a statement of purpose, which helps to inform prospective residents of the services that can be provided at Clifford House. This document includes photographs to help people make their decisions. The people who use this service told us that they were involved in the decisions to move into this home. They told us that they recieved enough information about Clifford House to help them with their decision to move in. The owner told us that people are able to visit the home and share a meal or spend the weekend with the people that already live at the home. This helps to make sure that the service will be suitable and able to meet their needs. It provides the owner with the opportunity to consider the needs and requirements of prospective residents in conjunction with the people who already use this service to help compatibility. The people that live at Clifford House have received an assessment of their care and Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: support needs, which was undertaken before they moved into the home. Assessments help the owner to make sure that Clifford House will be a suitable place for people to live. Care Homes for Adults (18-65 years) Page 12 of 31 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. People using this service are able to and do make choices about their everyday lives. Care plans and risk assessments are not properly maintained, which could sometimes result in assumptions being made about the support needs of people using this service. Evidence: The people that live at Clifford House have individual care records. During our visit to the home we looked at a sample of two records. The records provide information about the individual wishes and goals of the people that use this service. They also provide details of the people that are important to them in their life. The records contain a lot of information about each person, but they are not maintained in an organised manner or used as a working document. This results in inconsistencies with recording important information about each persons needs and support requirements in their plan of care and could lead to people making assumptions about their needs. The home offers family style living to a small number of people. The owner knows them Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: very well and during discussions she was able to provide detailed verbal information about the care and support needs of all the people living at Clifford House. The plans are reviewed regularly and with the involvement of the individual and their social worker or family representative. The owner could improve the way in which reviews are recorded. This will help ensure that reveiws are undertaken as frequently as they should be and that care plans accurately reflect the support needs of the people that use this service. The people that live at Clifford House told us that they are able to make decisions about all aspects of their life. They are able to choose what they want to do during the day, evenings and at weekends, although most of them attend day centres or employment during the week. People told us about the holidays they enjoy and one of the people we spoke to told us that they have booked to go to New York for a holiday later in the year. Care records contain limited information with regard to risks and risk taking. Some records are kept where people need support with mobility, but again this is limited. The owner is able to give verbal updates, but this is an area that she needs to improve upon to ensure that clear and detailed records are maintained. Care Homes for Adults (18-65 years) Page 14 of 31 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. People using this service make decisions and choices about their lifestyle. They are encouraged and supported in participating in valued and fulfilling activities. Evidence: People using this service tell us that they are usually able to make choices about their daily routines. They are able to do what they like in the evening, daytime and weekend. People told us that the owner listens and acts on what they say. Some of the people go to work during the day. We met one person who was waiting for her taxi to take her to work on the day of our visit. She told us that she enjoys going to work and described some of her tasks with enthusiasm. The home offers family style accommodation and living. People using this service are encouraged to participate in this style of living. One person told us that they have chores to do - loading dishwasher, laying/clearing table and tidying their own room. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: The owner is very aware of the different needs and wishes of each individual living at Clifford House and tries to ensure that their leisure interests are supported as much as possible. One person no longer wishes to go out into town but enjoys quieter activities and bar meals. Another recently took an interest in holidays abroad and she has been supported to do this. Separate holidays and activities are arranged for the differing needs and interests of people living at this home. The owner told us of the plans she is making to arrange a night out into to town with other community groups for those people who still want to participate in this type of activity. People using this service are supported and encouraged to have relationships with their friends and family. Some people spend the weekend at home with their families. The owner told us that most of the activities are arranged with everyone in mind, but a large percentage are also based on individual choices and one to one support is often provided to people using this service. People are encouraged to participate in daily life skills such as ironing, laundry, doing the dishes or setting the table. They enjoy helping with food shopping and choices for meals are made on the day as in a traditional family setting. One person particularly commented on the food and told us that they like the meals a lot. All residents have their own bank account and manage some of their own finances on a day to day basis, other support is provided by their families. Care Homes for Adults (18-65 years) Page 16 of 31 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 using this service have access to healthcare professionals and are supported to attend appointments. This helps to make sure that their physical and emotional health needs are met. Evidence: The people living at Clifford House are able to make choices about their daily lives, clothes, hairstyle and appearance. They tell us that the owner and staff at the home treat them well and that they listen and act on what is said to them. Some of the people told us that the owner is very good with them and is kind and caring. People appear to be well cared for and supported with their daily needs. The lack of detail contained in their plans of care makes it difficult to verify whether all their needs and choices are respected and met appropriately. Records show that people have access to healthcare professionals and that the owner ensures appropriate healthcare advice and support is sought when needed. People have access to their doctor and community nurses and are supported to attend hospital appointments and womens health screening appointment. People also attend regular appointments with opticians, dentists and chiropodists. The owner at the home maintains responsibility for the Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: management and administration of medication. The lack of detail in care records and risk assessments makes it difficult verify that people using this service are given the option to retain control over their medication requirements. Medication is generally kept secure in a locked room. Records are kept of medicines coming into and going out of the home. The owner has devised a system to help prevent medication errors occurring when people go home to their families for the weekend or on holiday. A form has been developed recording the amount and type of medication given to the family, for the correct number of days and a responsible person signs to say that they have taken it away from the home. The owner keeps medication administration records but these are completed with a tick rather than signed by the person administering the medicine. We observed the practice of putting evening medications out in the morning. The medication record sheet had also been ticked as administered. We spoke to the owner about this as it is poor practice, which could result in medication errors being made. The owner and staff member are booked on foundation and advanced medication training in April 2009. This training should help them understand medication procedures better and adopt safer practices when administering medication. Care Homes for Adults (18-65 years) Page 18 of 31 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. People using this service are able to raise concerns and know that they will be listened to and taken seriously. Evidence: There is a complaints process in place at the home to help people wishing to make comments or complaints. The process is available in one written format, which may not meet the communication needs of all the people living at the home. Two of the people that live at Clifford House told us that they did not know how to make a complaint. However, all of the people that live there told us that they know who to speak to if they are not happy about something or have a concern. They told us that the owner and the staff listen to what they say and act on their comments. Clifford House provides a family lifestyle for the people that live there. They are confident about raising issues with the owner and any problems are usually dealt with quickly. Most of the people that live at Clifford House have daily contact with other services or their families. Social workers carry out frequent reviews of their support needs. This helps to provide people with a variety of opportunities to raise any concerns they may have. Most of the people living at the home are in charge of their own finances or receive some support from family members. They have their own accounts and are encouraged to save for holidays etc. People living at this home are supported to ensure they receive the benefits they are entitled to. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: The owner and staff at Clifford House have undertaken some training in the protection of vulnerable adults (abuse). The owner has a copy of the local authority guidelines with regard to reporting suspicions and allegations of abuse. Records were available to demonstrate that the owner deals with concerns or allegations appropriately, involving social workers and/or health care professionals as necessary. Care Homes for Adults (18-65 years) Page 20 of 31 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. Clifford House provides people with a warm, safe and comfortable environment in which to live. Evidence: As part of our visit to this service, we looked around the home. One of the people that live at Clifford House accompanied us on our tour of the home. The home is well maintained and tastefully furnished and decorated. Clifford House provides a comfortable and homely environment for the people that live there. There is a large, family style kitchen, sitting room and conservatory. The home has garden areas, which the owner said were being improved over the winter so that people can access them in the summertime. People living at the home told us that it is always clean and fresh. Everyone has their own room and are able to personalise it to their own taste. They have been able to choose the colour scheme for their rooms and choose the soft furnishings. People living at the home take some responsibility for keeping their rooms clean and tidy. Individual bedrooms are all fitted with a hand wash basin. There is a bathroom/shower room on the first floor and a shower room and separate toilet on the ground floor. The owner has undertaken formal training in the control of infection and basic food hygeine, which helps to ensure the risks of infection are minimised. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: The laundry at the home is situated in a small utility room and is separate from the kitchen and dining area. This also helps to minimise any risk of the transfer of infection. The owner told us that the premises were visited by the environmental health officer in 2008 and that they found everything satisfactory. Care Homes for Adults (18-65 years) Page 22 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are supported by suitable staff that understand their needs and requirements. Evidence: The home is run as a family business. Mrs Graham is the owner and takes responsibility for the majority of care and support provided to the people that use this service. She is assisted on a regular basis by one other member of staff and on occasions by three others, all of whom are members of her family. All the people that work at Clifford House have received appropriate checks such as criminal records bureau (CRB) and protection of vulnerable adults (POVA) checks. This helps to make sure that they are suitable to work with vulnerable adults. The home does not have a training and development plan but the owner tries to make sure that she keeps herself and her staff up to date with changing legislation and good practice issues. Two of the staff members are currently studying for a national vocational award (NVQ) in care. Some of the people who work at the home, including the owner, have undertaken a Red Cross first aid certificate, received training on the subject of safeguarding and abuse and an introduction to the Mental Capacity Act. The owner provided evidence of further training that is planned for the next few months, for example training in the administration of medication, tissue viability and skin care Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: and mental health awareness. Training of this type will help ensure that people working at the home have the skills and knowledge to support the residents. Care Homes for Adults (18-65 years) Page 24 of 31 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 owner of Clifford House is experienced and qualified and tries to ensure that the home is run in the best interests of the people that live there. Evidence: Clifford House is owned and managed by Mrs Oriel Graham. Mrs Graham is experienced and qualified to run the home within its stated purpose, aims and objectives. She has gained the Registered Managers Award and has undertaken courses in other subjects such as first aid, infection control, food hygeine and safeguarding adults (abuse). She has plans to undertake further training in the next few months. The home provides support to the people that live there in a family style setting. There is no formal quality assurance process in place at the home. However, there are some policies and procedures in place to help ensure the home is run effectively, safely and to help protect the people that live there. The home is also the home of the owner, she lives with the residents at all times. She has daily contact with the people that live there and regular contact with their friends, family or social worker. The people that Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: live at the home tell us that staff listen and act on what they say. The staff training records do not demonstrate that manual handling training has taken place. People using this service are generally independently mobile, although some people do use wheelchairs for moving longer distances outside of the home. The owner should ensure that people working at the home have had some instruction in the safe techniques of moving and handling people and objects. There is an action plan for evacuating the home in the case of fire and the manager has produced an easy read poster to help people living at the home to understand the process should a fire occur. The owner has not produced a fire risk assessment and this is something that she must do without delay to help ensure that the home is safe and to meet the requirements of the law. There are other aspects of health and safety at the home that would benefit from a review. For example the central heating is not routinely serviced. The portable electrical appliances are not tested regularly and these omissions could place people living at Clifford House at risk from harm or injury Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes R 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 24 16 The home must have a landline telephone 31/10/2006 Care Homes for Adults (18-65 years) Page 27 of 31 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 6 15 People using this service must have a comprehensive plan of how their care and support needs will be met and managed safely. Care plans provide the basis to ensure appropriate care and support is give to each individual. Where people have specialist needs, clear strategies and plans must be in place to help ensure that staff manage situations safely. 31/03/2009 2 9 13 You must make sure that people living and working in the home are protected as far as practicable from the risk of harm or injury. People living at the home must be supported safely at all times. Safe systems of work and assessments of risks help to promote safety and reduce the risks of harm or injury. 31/03/2009 Care Homes for Adults (18-65 years) Page 28 of 31 3 20 13 Records for the administration of medications must be maintained accurately. Accurate recording helps to protect people from errors. 13/03/2009 4 20 13 Arrangements must be in place to ensure the safe administration and secure storage of medications kept at the home. Medications must be stored and handled in line with legislation and good practice. People using this service must be protected from the risks of receiving medication in error. 13/03/2009 5 42 13 People working at the home 31/03/2009 must receive formal instruction and training in the safe techniques of moving and handling objects and people. Moving and handling training helps to ensure that both staff and people using this service are protected from harm or injury during lifting or handling procedures. 6 42 23 The home must produce and 31/03/2009 maintain a detailed fire risk assessment that meets the requirements of the fire and rescue authority People using this service must be protected from the risks of harm or injury. Care Homes for Adults (18-65 years) Page 29 of 31 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 22 Consideration should be given to producing an easy read complaints process, that meets the communication needs of the people that use this service. Consideration should be given to the safety testing of portable electrical equipment in the home. It is recommended that these tests are carried out on a regular basis to help ensure the safety of people living and working at the home. Consideration should be given to the servicing of the central heating system and associated appliances such as boilers. It is recommended that this is carried out annually to help ensure the safety and well being of people using this service. 2 42 3 42 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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