Inspection on 02/12/08 for Coronation Road, 63

This inspection was carried out on 2nd December 2008.

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

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

Other inspections for this house

Coronation Road, 63 05/12/06

Coronation Road, 63 16/11/05

Coronation Road, 63 23/05/05

Coronation Road, 63 19/01/05

Coronation Road, 63 16/08/04

Coronation Road, 63 25/03/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Coronation Road, 63 Coronation Road, 63 Southville Bristol BS3 1AR     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: Jacqueline Sullivan     Date: 0 4 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. 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Coronation Road, 63 Coronation Road, 63 Southville Bristol BS3 1AR 01179077217 01179709301 max@aspectsandmilestones.org.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) : Aspects and Milestones Trust care home 6 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 6 May accommodate up to 6 persons aged 35 years and over Date of last inspection Brief description of the care home 63, Coronation Road is operated by Aspects and Milestones, which is a voluntary organisation. It is registered to provide personal care and accommodation for up to six people who are thirty-five and over and who have mental health needs. It is a settled household that would suit those who prefer a quiet and calm lifestyle. The home aims to encourage residents to live independent and fulfilling lives within a community setting. It is a four storey Victorian house overlooking the river, which blends in well with local surroundings. It is close to Bedminster shopping centre, major bus routes and local amenities. It benefits from a large front garden and smaller porch area to the rear with some parking space.The cost of placement is 550 pounds per week. Additional charges are made for transport and chiropody services. Prospective residents can be provided with information about the home and this will detail the services and facilities available at the home. Care Homes for Adults (18-65 years) Page 4 of 28 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 inspection was unannounced and took place over two evenings. Evidence was gathered from a number of different sources. Information taken from the pre-inspection questionnaire,directly speaking with residents,case tracking a number of residents,focusing on the specific care of residents including admission and care planning with evidence from reading their files,speaking with care staff,a tour of the premises,examination of some of the homes records and observations of staff practices and interaction with the residents. The home manager was present during the inspection and assisted in the inspection process Care Homes for Adults (18-65 years) Page 5 of 28 Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The residents would be more able to make a more informed decision about whether to live at the home if the information available to them were updated. The residents would be better protected if their care plans were reviewed to reflect their changing needs. The residents would be safer if the risk assessments completed by the staff team were updated to reflect any changes. The residents would live in a more homely environment if the basement had some remedial work to prevent damp penetration from the skylight. The residents health needs would be better met if their health assessments about selfmedication were updated. The residents would be more assured that the staff team were working consistently if staff meetings and key worker meetings were in place. Care Homes for Adults (18-65 years) Page 7 of 28 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 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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 homes admission procedure ensures that placement is only offered to those whose needs can be met. The residents would be more able to make an informed decision about whether to live at the home if the information available to them were updated. Evidence: The homes brochure and service user guide contains photographs of the home which were taken by a service user providing an visual idea of what the home would be like to live in. The resident had been credited for the photography in the brochure. At the last inspection it was required that the contact details of the commission must be revised to bring the information fully up to date. This was seen to be completed. However the information needs to include the new managerial arrangements and the arrangements for smoking outside the building. The brochure contains information necessary for a prospective resident to make an informed decision about moving to the home and includes details about rooms occupied. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: No new residents had been admitted since the last inspection. All residents contracts were signed and dated. At the last inspection it was required that the contracts did specify the room occupied. At this inspection these were seen to be in place. Three case files were seen and each contained a detailed initial assessment from which subsequent care plans were based. Care Homes for Adults (18-65 years) Page 11 of 28 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. Residents cannot be assured that their changing needs will be reflected in their care plans. Residents are involved in their care planning and making decisions and are supported in achieving goals to improve their lives. Residents are supported to take risks but they cannot be assured that their assessments will be reviewed by the staff team. Evidence: As noted at the last inspection the residents spoken with were able to describe busy lifestyles and how they make decisions. At the last inspection it was noted that the home has a good track record in supporting residents to encourage confidence and continual improvement in residents lives which was found again at this inspection. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: At the last inspection the care files case were seen to be up to date and contained key information showing goals to be achieved and were person centred. However, at this inspection the files were seen to be in need of some reorganisation and revision. Three files were looked at and these were seen to be bulky and the information was difficult to find. In one file we were unable to find all the parts of the 2008 care plan. Not all the parts of the care plan had been updated and the plans that were there were not in date order. One file has notes dating back to 2003. The manager said that the staff team were used to the files. However, if a new member of staff worked at the home they would struggle to easily get information about the people they were caring for. The staff team are not assisted by not having a computer. Consequently the plans contain handwritten crossing outs and updates. The manager said that he expects the home will have a computer by January 2009. The manager said that one resident would probably be moving for additional support. However this was not reflected in this persons care plan. At the last inspection it was noted that the risk assessments which had been reviewed were detailed and identified the risks for each resident. At this inspection it was seen that they are now not being reviewed consistently. One risk assessment seen in relation to dealing with aggression gave the number of a home, where the staff team could contact for support and advice, but this home is no longer operating in that form so the number is no longer relevant or useful. This must be updated. Key worker meetings between staff members and the people they care do not take place monthly. A recommendation has been made about this. A staff member said they used to talk about residents in their staff meetings however these no longer take place. Residents spoken with were able to describe the choices they make. Some choose to do chores and others choose to go out and buy the food for the home each week. Care Homes for Adults (18-65 years) Page 13 of 28 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. Residents have many opportunities and enjoy a stimulating and varied lifestyle. Residents enjoy a full involvement in menu planning purchase and good meals. Evidence: Residents are encouraged to lead independent lifestyles. Their daily life schedule and activities are recorded. Four files were case tracked and these showed that residents could choose whether to take part in planned activities. One resident has a particularly full day. They were returning from playing football on the first day of inspection. They were greeted enthusiastically by the manager who took time to have a chat. This resident said they were happy with the activities they took part in. We asked if they did a lot in the evenings. They said they might like to do some things. Consideration Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: should be given to offering evening activities. One resident spoken with said they go for a walk every day. Residents enjoy a range of activity including music and guitar,City of Bristol College City farm, Bristol MIND and Hippodrome concerts. Two residents who were spoken with said that they were happy with the level of activities that they took part in. Each resident has a job around the house. The manager said this is to develop independence. These include emptying ashtrays and bins and laying the table. We saw that frequent residents meetings take place where decisions on activities and meals out are planned. Discussions with staff members, residents and information in the communication book showed that visitors are welcome at all time Discussions with staff members, residents and information in the care files confirmed that recent holidays have included trips to Portugal, Blackpool lights, North Wales and Weymouth. As noted at the last inspection, residents independence and equal opportunities was promoted strongly in the standard concerning meals. Three residents choose to self cater and have their own allowance for this. On the day of inspection, two residents were seen making their own meals. The manager said that each resident receive three pounds to make themselves a meal. He said that this keeps peoples hand in and helps with ownership and choice. The manager explained how two residents who go out each week to purchase the main shopping for the home. Once they have completed the shopping, they use the home mobile phone to ask staff to collect them with the shopping. This was confirmed by the residents. One resident said they agree menus at the weekly Sunday meetings where they talk about healthy eating and choose what they would like to eat. The menus were seen to contain a variety of healthy well-balanced foods. Care Homes for Adults (18-65 years) Page 15 of 28 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. Residents can be assured that their health needs will be met because the home has good care planning processes in place. However the residents would be more assured that the staff team were working consistently to support them if the information in their health assessments were updated. Evidence: Three residents files were case tracked and it was seen that there was recorded evidence that the staff team work closely with health professionals to ensure the residents health needs are met. The medication system was examined. As noted at the last inspection, four residents self medicate demonstrating support for residents responsibility and independence. However discussions with staff members, residents and evidence in the care files confirmed that the residents health assessments and risk assessments in relation to self - medication need updating, as on two care files the information was seen to be out of date .For example, the information about where a resident picks up their Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: medication had changed since the last assessment. The medication cupboard was seen to be well organised and locked. A staff signature list was seen at the front of the medication book to show who had been responsible for medication and, except for one occasion staff had signed the medication sheets correctly. A stock control was completed on a monthly basis. This was seen to be kept appropriately. Both the acting manager and the member of staff present at the inspection were able to demonstrate a good knowledge of the residents health needs. They described the work that has taken place with one resident who needed additional support. Care Homes for Adults (18-65 years) Page 17 of 28 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. Residents can be assured that any concerns they have will be listened to and acted upon. Residents will be cared for by staff that are aware of abuse issues and will safeguard them from harm. Evidence: Two residents were spoken with at this inspection. One was aware how to complain the other was not sure. Consideration should be given to including this topic in residents meetings. Both residents said they would talk to staff members who they felt would listen to them and confirmed that they felt safe in the house. There have been no complaints in the last twelve months. Discussions with the manager and training records showed that the staff team have received recent safeguarding training. Both the manager and member of staff on duty were able to demonstrate knowledge of POVA (Protection of Vulnerable Adults) procedures. Care Homes for Adults (18-65 years) Page 18 of 28 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. Residents live in a homely and comfortable property which meets their needs well and is in a good location to local shops and the centre of Bristol. Evidence: Over the two evenings of inspection we noted that the house was warm, homely and inviting. Since the last inspection there have been some improvements made. In the kitchen there are two new ovens, a new kettle, washing machine, microwave, vacuum and tumble dryer. The home was seen to be clean and tidy and one resident spoken with said thatthey helped keep it clean. Since the last inspection the dining area has been refurbished with a new floor and been newly painted. This area is particularly well used by the residents and is a relaxing space. We noted that the residents were watching and talking about what they were watching on the television. The fridge was seen to be well stocked with nutritious food and the temperatures of Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: the freezer and the fridge were recorded appropriately There are two lounges. One is used by the two ladies living at the home and the other mostly by the men. Several residents were seen eating in both rooms and chatting together. One resident offered to make us a cup of tea which showed how at home people felt in the house. The managers pre -inspection questionnaire provided comprehensive detail with dates about the completion of mandatory checks. At the last inspection it was noted that the bathroom floor on the first floor needed replacing as it was beginning to be stained. The ceiling in the second floor shower room showed signs of a very small area of marking as it joined the wall and a small crack needed attention. At this inspection these were seen to have been repaired. At the last inspection it was noted that a lounge carpet should be replaced. At this inspection it was noted that a new carpet was in place. Discussions with the staff team and evidence in the residents meetings book confirmed that the residents chose the colour. As it is a light colour the residents themselves suggested that they remove their shoes to keep it clean. We toured the building and noted some points for attention. The basement has some damp penetration from the skylight. The manager said this was to be repaired shortly. Care Homes for Adults (18-65 years) Page 20 of 28 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. The residents are protected as an established staff team, who are trained and skilled to meet their needs. The residents would be more assured that the staff team are working consistently, if the systems in place to support the staff members care for them were improved. Evidence: As noted at the last inspection a stable staff team continues to work at the home and three of the four staff have achieved an NVQ National Vocational Award. Staff training included epilepsy, in house fire training and refresher food hygiene. The last inspection found that the staff files contained the required information and there were no noted concerns At this inspection the information were locked away, with the manager having the key therefore these were not looked at. This will therefore be a focus of the next inspection. A member of staff spoken with said that teamwork at the home was very good. The staff team is stable with many working there for several years. The interactions seen Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: between the staff member on duty at the time of inspection and the residents were positive and thoughtful. Discussions with staff members, evidence in the diary and discussions with the manager showed that supervision sessions take place but these are not all at the recommended frequency. A staff member said that they have many informal supervision sessions. Staff meetings are not taking place at the moment. Staff communicate via the communication book which was see to be detailed. Recommendations have been made that the frequency of supervision is improved and that staff meetings take place. Both are useful support systems for staff to enable them to work consistently in caring for the residents. Staffing levels met residents needs on the day of inspection and the manager keeps staffing under review. On both evenings of the inspection one member of staff was working alone. On the first evening this was the manager and on the second evening a support worker. We were told that if there is a problem then they could contact the manager and there is an out of hours on call system in place. We asked to see their working alone policy but this was not in place. Care Homes for Adults (18-65 years) Page 22 of 28 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. Effective positive leadership ensures that the management of the home is good and the home is run in the best interests of residents. Evidence: The new acting manager has been in post since 2007 when the substantive manager went on maternity leave. He said she was due back in February 2009. The Commission must be informed when this takes place. The acting manager is a Registered Mental health Nurse. He was able to demonstrate reflective practise and good leadership although points have been made elsewhere about the reorganisation and updating of the care plans. Discussions with the residents, staff team and evidence in the care files confirmed that he listens to and responds to the residents views. A staff member described him as being supportive. Two residents spoken with said Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: that they liked him. The manager presented as relaxed and was seen to have a good relationship with the residents who responded positively towards him. Discussions with the staff team and evidence in the residents files confirmed that the manager delivers good outcomes for the residents but both the manager and the staff team have to be careful that their good standards do not slip. The information in the care files showed that, although the staff team may be used to them, they are not easily accessible to by other readers and need some work. The reviewing systems are not as effective as they were at the time of the last report and the support systems for staff to ensure consistency were also not as robust as at the time of the last inspection. As noted at the last inspection this report shows good evidence of residents being confident that their views are listened to. Significant progress had been made concerning quality assurance and self-monitoring. In September 2006 the provider produced a new quality assurance tool. This remains in place. Residents views are sought within this system. The representative for the provider makes monthly unannounced visits, copies of which were available. At the last inspection it was required that the manager review the policy concerning reporting of incidents to ensure that all important information, which may effect the wellbeing of a resident is communicated properly to the commission. At this inspection this was seen to have been completed. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 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 1 5 The registered provider 04/04/2009 must ensure that the service user guide includes the new managerial arrangements and the arrangements for smoking outside the building This will ensure that the residents have fuller information 2 6 15 The registered provider must ensure that the residents care plans are reviewed to reflect their changing needs. And ensure that these careplans are reorganised. This will ensure that the residents are protected as the staff team will have fuller knowlegde of their needs. 03/03/2009 3 20 12 The registered provider must ensure that the residents health assessment and risk assessments about self medication are updated 09/03/2009 Care Homes for Adults (18-65 years) Page 26 of 28 To ensure residents health needs are met. 4 24 16 The registered provider must ensure that the basement has some remedial to prevent damp penetration from the skylight. To ensure the home is homely for the residents 03/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 4 6 9 35 36 The registered provider should ensure that care files are reorganised The registered provider should ensure that risk assessments are reviewed The registered provider should ensure that a working alone policy is available at the home. The registered provider should ensure that staff meetings and staff supervision are more frequent. Care Homes for Adults (18-65 years) Page 27 of 28 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. 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