Inspection on 28/10/08 for Copperbeech

This inspection was carried out on 28th October 2008.

CSCI found this care home to be providing an Good 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Copperbeech 05/03/07

Copperbeech 27/02/06

Copperbeech 15/09/05

Copperbeech 15/03/05

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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: Copperbeech Copperbeech 75-76 Penkett Road Wallasey Wirral CH45 7QG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Helen Carton     Date: 2 8 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 31 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 31 Information about the care home Name of care home: Address: Copperbeech 75-76 Penkett Road Copperbeech Wallasey Wirral CH45 7QG 01516391405 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Karen Scregg Type of registration: Number of places registered: Mannacom Ltd care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: 3 named service users over 65 years of age (MD/E) within the overall total of 25 Date of last inspection Brief description of the care home Copperbeech is a large three storey detached property that was registered in February 1991 for the care of people with mental health problems. It is situated in an urban location within easy reach of Liscard and New Brighton town centres which both have a selection of shops, banks and community facilities. The area in which the home is situated contains many other residential homes providing care for other vulnerable groups of people. The home is situated in its own grounds with parking space for about six cars. There is a large garden at the back of the home with a patio. Accommodation is provided in 14 single and 3 shared bedrooms all with en-suite facilities. Three flats in the basement provide more independent accommodation. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 25 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. As part of the inspection process we sent Copperbeech an Annual Quality Assurance Assessment (AQAA) document, which was completed prior to the site visit. This document was to provide information about the service at Copperbeech and to tell us where they felt they had made improvements to the way they support service users and the staff team. As part of the inspection process surveys were sent to eight service users and five members of the staff team, a total of 10 responses were received. Care Homes for Adults (18-65 years) Page 6 of 31 The last inspection on this service was completed on 05/03/07 We visited Copperbeech to enable us to look at records and to discuss how the service supports service users in all aspects of their lives. Part of this process involved speaking with the manager, members of the staff team and spending time with service users to find out their views on living at Copperbeech. We spent approximately 8 hours at Copperbeech. What the care home does well: Copperbeech makes sure they consult with prospective service users, other professionals involved in supporting them and family members to ensure they can meet their care needs and lifestyle choices. This practice promotes confidence in the ability of the service to support and enable service users to make an informed choice as to whether Copperbeech is where they wish to live. The following comments were made during our visit to Copperbeech and in returned service users surveys: Yes I was asked if I wanted to move into the home. I had enough information about the home before I moved in to decide if it was the right place for me. The manager, the staff team and the registered owners work hard to gain the views and opinions of service users about the care and support being offered to them. This includes involving service users in the production of support plans and risk assessments, service users are encourage and supported to sign these documents as an agreement to the support to be provided.The following comments were made during our visit to Copperbeech and in returned service users surveys : Ive been in lots of other places this is the best. Since M and G took over its been much better the place is so nice and they listen to me. The staff always listen and act on what I say. Service users told us that they are supported to remain as independent as possible, to maintain daily living skills and to develop their own daily routines including social activities. The following comments were made during our visit to Copperbeech and in returned service users surveys : The staff really look after me and are interested in what I do during the day and love to look at the things Ive bought from the local shops. I see my family regularly and they are made to feel welcome when they visit the home Service users health-care needs including their mental well-being is monitored by the service and they are supported to access health-care services. There is a complaints policy and procedure and safeguarding adults procedure. Service users told us that if they were unhappy or concerned about how Copperbeech was being managed or they felt they were being neglected or bullied they would talk to the manager, the owners, family members or other professionals who support them.The following comments were made by service users: Yes I do know who to speak to if I am not happy. Yes staff treat me well. If Ive ever had any niggles about anything my key worker or Karen always try and sort things out or explain why something has to be a certain way. Care Homes for Adults (18-65 years) Page 8 of 31 Members of the staff team spoken with demonstrated a good understanding about how to best support and safeguard service users whilst understanding and respecting their individual lifestyle choices. The manager and the registered owners support the staff team to undertake appropriate training such as National Vocational Qualifications (NVQ). During our visit we observed the manager and members of the staff team supporting service users in a respectful, sensitive and affectionate manner. 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 Care Homes for Adults (18-65 years) Page 9 of 31 240 7535. Care Homes for Adults (18-65 years) Page 10 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 11 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. The Pre- admission assessments identify the care and emotional needs of prospective service users resulting in a service that can support the lifestyle choices of the people who live there. Evidence: Before a person is made an offer to live at Copperbeech the manager or senior member of staff will carryout an assessment of their care needs. This assessment will include gaining information from the person wishing to move into the home, other health and social care professionals supporting them and where appropriate family members and friends. We looked at a selection of service users care files which showed assessments are carried out prior to them moving into Copperbeech, with this information then being transfered into care plans and risk assessments. We discussed with the manager the need to make sure where an issue of concern is raised about a service user presenting with aggressive or risky behaviours this information is discussed with other professionals involved in their care and an Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: agreement reached as to how to best support the individual during these times. Service users spoken with confirmed the manager or senior staff visited them and spoke to them about their care and emotional needs before they moved into Copperbeech. The following comments were made during our visit to Copperbeech and in returned service users surveys: Yes I was asked if I wanted to move into the home. I had enough information about the home before I moved in to decide if it was the right place for me. Care Homes for Adults (18-65 years) Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users preferred routines, lifestyle choices and mental wellbeing is supported by the services care planning and risk management strategies. Evidence: We looked at a sample of care plans which provide the staff team with information about the mental health, emotional and physical health needs of service users. Service users with their key workers are involved in the production of these documents and where possible are asked to sign them to show they agree with the support they are to be offered. We discussed with the manager the need to develop service users personal history profiles to provide the staff team with information about their lives prior to living at Copperbeech. The manager told us some service users do not like to talk about their Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: past lives. We acknowledged this but advised where possible information should be sought and documented as currently significant information is being verbally held by some staff members and not others. Documenting this type of information would enable the staff team to support service users in a consistent supportive manner during personally difficult times. Service users told us they felt the staff team like them and support them in a sensitive and friendly manner. The following comments were made during our visit to Copperbeech and in returned service users surveys: Ive been in lots of other places this is the best. Since M and G took over its been much better the place is so nice and they listen to me. The staff always listen and act on what I say. We looked at a sample of risk assessments and review information we discussed the following issues with the manager: In a small number of plans the reviewing information contradicted the support plans leaving service users at risk of receiving inconsistent support and supervision. The manager acknowledged this and told us she would amend the documentation following input from service users and from the other health and social care professionals involved in supporting them. The following comments were made during our visit to Copperbeech and in returned service users surveys : I always make decisions about what I want to do each day. My room is exactly how I like it in other places Ive lived I wasnt allowed to make it my own. Members of the staff team spoken with showed a good understanding of service users needs and were respectful of their right to live their lives as they wish. Care Homes for Adults (18-65 years) Page 15 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. Service users lifestyle choices are supported and promoted by the manager and staff team resulting in a service that is service user focused and promotes independence and choice. Evidence: Service users spoken with told us routines were very flexible and that the manager and the staff team encourage and support them to make decisions about what activities they wish to take part in. Many said they arrange their own daily routines and spend their days as they wish including accessing community and leisure facilities on a daily basis. An activities coordinator is employed to support service users with social and leisure activities and to promote a therapeutic environment to encourage service users to Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: develop positive relationships with fellow service users and the staff team. The following comments were made by service users during our visit to the home. A is my key worker but I also think of them as a friend. Hi love this is a great home everybody helps everyone else. The staff team respect me and understand when Im feeling unwell The staff really look after me and are interested in what I do during the day and love to look at the things Ive bought from the local shops. We looked at a sample of care plans which provided information about the significant relationships in service uses lives. Services users spoken with confirmed the manager and staff team support them to stay in contact with people who are important to them. The following comments were made by service users: I see my family regularly and they are made to feel welcome when they visit the home My friend visits an stays for lunch he is always made welcome. Service users are encouraged and supported to be involved in daily life tasks such as keeping their bedroom tidy and being involved in doing their laundry. This promotes service uses independence and helps them to maintain life skills. We spoke with several service users about the quality of the meals provided all happy with the quality, quantity and variety of meals provided. Service uses also commented that if you they did not like a meal being offered an alternative would be provided. Service users told us that the manager and staff team encourage them to have their meals in the dining room however if theyve been out or just feel like eating alone their meals are taken to their bedrooms. There are currently no service users involved in paid or community work. Care Homes for Adults (18-65 years) Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users personal and healthcare needs are met by a supportive and flexible care service. Evidence: Information about the type and level of support service users need with their personal care needs are documented in care plans and where necessary risk assessment support plans. Service users told us the staff team are sensitive and respect their privacy. Records show service users are supported to access health care services to maintain their physical and mental wellbeing. Records also show that guidance and support are sought from specialist services when specific care needs are identified. We advised the manager to discuss with individual service users, health and social care professionals the action to be taken if they refuse emergency medical treatment. This is to ensure all parties are aware of possible consequences and a consistent approach is adopted to safeguard service users. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: For the majority of the service users the manager and care staff team administer their medications with consent forms signed by individual service users and their key workers held in their files. We looked at a sample of service users medications and the accompanying Medication Administration Record (MAR) sheets, they were well maintained.The medication is securely stored with a clear procedure for the staff team to follow whilst administering medication. Information sheets about all medication administered is available as reference material for the staff team. We advised the manager to discuss with the prescribing GP concerns about service user who regularly refuse to take their medication. This is to ensure GPs are given the opportunity to review individual service users medical treatment plans. Care Homes for Adults (18-65 years) Page 19 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. Service users views and opinions are sought and acted upon. Resulting in a care service that proactively works to protect them from possible abuse and neglect. Evidence: Service users spoken with told us they felt confident that if they were unhappy or concerned about the care and support being offered they would talk to a member of staff, the manager or the people who own the home. The following comments were made by service users: Yes I do know who to speak to if I am not happy. Yes staff treat me well. If Ive ever had any niggles about anything my key worker or Karen always try and sort things out or explain why something has to be a certain way. Members of the staff team spoken with demonstrated a good understanding about how to best support and safeguard service users whilst understanding and respecting their individual lifestyle choices. All members of the staff team including the manager had undertaken safeguarding Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: adults training within the last 12 months. Policies and procedures are place that give clear guidance and direction to the manager and the staff team on how to report allegations of abuse, neglect or poor care practices. The registered persons who own Copperbeech regularly visit and undertake regular checks of all aspects of the service. As part of these checks they spend time with service users checking that they are happy and are receiving the care and support they need. Service users spoken with confirmed their opinions are sought and valued. Care Homes for Adults (18-65 years) Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Copperbeech provides an satisfactory living environment for service users that meets their physical and social needs. Evidence: The AQAA data set indicates there is a continuing programme of maintenance and refurbishment. Overall communal areas provide service users with a satisfactory level of comfort. Bedrooms viewed were very personalised and reflected service users hobbies, interests and personal tastes. We noted the main lighting in bedrooms were strip lights this is not a homely or attractive form of lighting. We advised the manager a requirement would be made to ensure appropriate lighting is fitted in service users bedrooms. We noted that some radiators were very hot and could potential be a hazard to those service users whose mobility is limited and those with a cognitive impairment. We advised the manager to carryout a risk assessment to ensure service users safety is maintained. For service users who smoke many following a risk assessment are supported to do so Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: in their bedrooms, their is also a designated area in the activities room. However some service users prefer to smoke outside at the front of the house currently their is no shelter to protect them from bad weather. The manager told us she would look into providing some kind of temporary shelter during the winter months. All areas viewed were clean and tidy. Care Homes for Adults (18-65 years) Page 23 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. Service users are supported by a skilled workforce resulting in positive outcomes with regard to them receiving individualised support and care. Evidence: Records show and discussions with the manager and members of the staff team confirm they are supported to undertake training to enable them to offer appropriate care and support to service users. We discussed with the manager and one of the owners of Copperbeech the need to provide mental health awareness training to further support and enable the staff team to offer appropriate and effective support to service users. The manager told us she has found it difficult to access this type of training however would continue to seek it out. There are robust recruitment and selection procedures in place which provide safeguards to service users that they are supported by suitably skilled and competent people. Members of the staff team spoken with demonstrated a good understanding of service users needs and expectations. We observed members of the staff team spending time with service users in a respectful and affectionate manner, service users appeared relaxed and were confident Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: talking to members of the staff team and the manager. Members of the staff team spoken with told us they enjoyed their work and felt supported by the manager and the owners of Copperbeech. Service users told us they felt well supported and cared for by the manager and the staff team. Care Homes for Adults (18-65 years) Page 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management systems within Copperbeech promote the health, safety and wellbeing of service users. Evidence: Mrs Karen Scregg has been the registered manager for over five years she is qualified to NVQ Level 4 which is the recognised qualification for managers of care services. There are management systems in place which allows the running of Copperbeech to be audited and for the registered owners to be confident it is being run in the best interest of service users. Service users spoken with felt the manager, registered owners and the staff team listen to their opinions and views this was confirmed in surveys returned to us. Members of the staff team spoken with felt supported by the manager and the registered owners. They receive regular supervision and attend staff meetings with Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: both giving them the opportunity to voice their opinions or concerns. This information was confirmed in surveys returned to us. Comprehensive records are kept about the health and safety checks made to maintain a safe environment for both service users and the staff team, including fire safety checks maintenance records, and utility services. Care Homes for Adults (18-65 years) Page 27 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 23 The Registered Persons are required to ensure all parts of the building are maintained in a way that provides a more homely environment. 05/09/2007 Care Homes for Adults (18-65 years) Page 28 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 9 13 Risk assessments should be regularly updated to reflect the most up to date information This is to ensure service users safety is maintained at all times. 29/12/2008 2 19 13 Guidance and support must be sought from health care professionals when individual service users refuse to comply with medical advice. This is to ensure service users receive appropriate care and support can are 30/12/2008 3 24 13 A risk assessment must be 30/12/2008 carried out to ensure the temperature from uncovered radiators do not pose a health and safety risk to service users. This is to ensure service users live in a safe environment. Care Homes for Adults (18-65 years) Page 29 of 31 4 25 23 Suitable domestic style light 24/03/2009 fittings must fitted in service users bedrooms. This is to ensure service users benefit from living in an environment that is homely in appearance. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 Risky or challenging behaviour identified during the assessment process should be raised with the appropriate professionals to ensure consistent, safe care and support is offered. The manager and the registered providers should continue to seek out specialised training within the area of mental illness to enable the staff team to offer appropriate care and support to service users. 2 35 Care Homes for Adults (18-65 years) Page 30 of 31 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. Care Homes for Adults (18-65 years) Page 31 of 31 - 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. 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