Inspection on 10/10/08 for Faith Global Links Ventures Ltd

This inspection was carried out on 10th October 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

Faith Global Links Ventures Ltd 21/01/08

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Chesham House

Argyll House

Coopers Mill Ltd

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Upaya Ananda

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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: Faith Global Links Ventures Ltd 158 Galleywood Road Great Baddow Chelmsford Essex CM2 8YT     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: June Humphreys     Date: 1 7 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. 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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 30 Information about the care home Name of care home: Address: Faith Global Links Ventures Ltd 158 Galleywood Road Great Baddow Chelmsford Essex CM2 8YT 01245478797 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): fglvhousing@hotmail.co.uk Faith Global Links Ventures Ltd Name of registered manager (if applicable) Mrs Olufumike Olubunmi Adediji Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following categories of service: Care Home - PC to service users of the following gender: Both whose primary care needs on admission to the home are within the following categories: Learning Disability - code LD Mental Disorder, excluding learning disability or dementia - code MD Date of last inspection Brief description of the care home The home is positioned in a quiet residential street on the outskirts of Chelmsford in the village of Great Baddow and is easily accessible by public transport. The property is an end of terraced house with three double bedrooms, one bathroom, lounge, laundry room, kitchen and dining room and a small conservatory. There is a small garden and a garage to the rear of the property with a parking facility; there is on street parking opposite and at the rear of the house. The home has been registered for three people Care Homes for Adults (18-65 years) Page 4 of 30 care home 3 Over 65 0 0 3 3 Brief description of the care home who have learning or mental disabilities and it is expected that each person living in the home will have their own keys to the front door and their individual bedroom. There is one shared bathroom and there are no washing facilities in the individual bedrooms. The homes Statement of Purpose and Service User Guide provides up to date information and is given to prospective residents before they move in. The charges will range between #700 and #1000 per week depending on the assessed needs of the individual; toiletries, newspapers, magazines, confectionery and taxis are not included in the above fees. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 stars. This means that the people who use this service experience good quality outcomes. One Inspector June Humphreys visited the home unannounced on two separate occassions, the 10th and 17th October 2008. The home was previously inspected on the ST January 2008, but at that time the home was not fully operational, and no service users were living in the house. The people who live at the home were spoken to, and observed being supported and talking to the staff on duty. One of the service users showed me around the house, they showed me their bedroom and the facilities that can use. Care Homes for Adults (18-65 years) Page 6 of 30 The Inspector also talked to the staff and the Manager about what service users do during the day, and what they do when they are at home. Information was also gained from relatives, and proffessionals who know the service users well, and have also visited the home. A sample of records maintained in the home was looked at to ensure the health and safety of service users is considered, including a sample of care plans, supervision records, the staff rota, complaints, medication and accident records. The manager Mrs Adediji completed the Annual Quality assurance Assessment form (AQAA) which is a self assessment which indicates how the home considers it is meeting the National Minimum standards, and what improvements they will make in the next 12 months. Information from this document is used within this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 30 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 –03000 616161. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can expect to look at the homes statement of purpose and service users guide as part of the assessment process, but would benefit from compatiabity being part of the assessment, to ensure that their social and emotional needs will be met. Evidence: The service has been registered to provide care for adults with learning difficulties,and mental health needs. There is no restriction on the age, or range of people who move into the home. Therefore both young adults and older people can be placed who have either a learning disability or mental health need. A statement of purpose and service users guide is held within the home, and a copy is provided to all prospective service users. The statement of purpose contains sufficient information for the service user to make an informed choice about if they would like to live at the home. There is information about local community resources i.e. the library, the supermarket and Chelmsford town centre. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Two pre admission assessments were looked as part of the inspection. Peoples needs are fully assessed prior to moving into the home, but evidence was not available to demonstrate that consideration was given to the matching process of the people sharing the house. The accommodation is small, and with the range of people who could be offered support, it would be beneficial to demonstrate peoples social and emotional needs could be met by the issue of compatibility being part of the assessment and admission process. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can expect to have an individual care plan, and to be supported by staff to be fully involved in making decisions in their personal lives and in the running of the home; which means they can maximize their opportunities to become more independent. Evidence: The files of the three current service users were looked at, and held a range of significant information regarding Service users changing needs. This included a personal profile and background information, visits to medical professionals, reviews, physical and mental health care issues, protocols for visitors, and a record of significant events. A number of up to date risk assessments covering a range of relevant areas of perceived risk were included i.e. using the kettle, smoking and going out alone. However risk assessments for bathing were not available, and the information in the care plan did not consider the limited facilities and how this may Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: impact on service users day to day personal care routines. The people living in the home had complex needs, and behavioral guidelines were in place for all three people. The member of staff on duty on the first day of the inspection was aware of each persons guidelines, and demonstrated a clear understanding, and ability to interpret these when supporting the service users. Each service user is encouraged to take part in daily living tasks, for example being supported with meal preparation, washing up, laying the table, shopping. The staff and the service users have devised a rota, following discussions held within regular morning meetings, and key worker sessions each week. The service users feel this is effective, and people appear to enjoy being part of the running of the home. A Person Centred Planning approach is in operation in the home, and the manager advised that service users are involved in the development of their care plan. When speaking to service users this did not appear to always be the case. One person said I do have a care plan, but I cant remember being asked about it. Another person said I cant always do what I choose, I liked it better in the flat. One persons care plan had been signed, the other had not. Service users lead reasonably independent lives according to their varying levels of ability. Staff understand the importance of allowing them to take sensibly evaluated risks in order to enjoy a range of opportunities. The manager stated in the completed AQAA that We encourage our service user to get over there phobia by taking little steps. This involve a bit of risk on their part. We monitor this closely and We have a full documented CPA (care planning approach) review minutes for each client. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal development is encouraged for all service users, providing regular opportunities for people to participate, and interact within the community. Evidence: Each persons care plan provides information about their interests, abilities, things they like to do, and things they do not. There is good communication between the staff and service users, and also the colleges and day centres that people attend. This means that if an incident occurs whilst out of the home, staff are aware of this and can ensure the person is given the opportunity to talk about it when they return home. One person had chosen not to continue with their college course and staff had worked hard to try to support the person to attend. Another persons day centre placement had not worked out. This meant that from the information recorded in daily care notes Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: people did spend a large amount of time in the house. The staff member said that it was very difficult to introduce new activities to the current service users, as they often lacked motivation, due to past poor experiences. The manager advised that activities were continually reviewed, and stated in the AQAA that All our Service users are engaged in daily activities as part of their daily routine. This includes relaxation, art and crafts, healthy lifestyles, and a chill out group. Service uses are unrestricted in movement around the home. They have a key to the front door, and their bedroom. Clear guidance was available relating to staff access to service users bedrooms, and permission is sort prior to entering. The service encourages involvement from families, who both visit the home, but also invite their relatives to stay with them. Preparations for the weekly food-shopping and menu were being finalized during this inspection. The lists evidenced that a range of different foods were regularly offered including fresh fruit, and vegetables. It had sometimes been difficult to gain a consensus between service users on what they would like to eat, and separate meals for each person were cooked. Ready meals are sometimes used to encourage service users to independently cook with limited supervision, as are take away meals. The manager commented on how the people were now working together to choose the weekly menu, and that choices had changed with less fried food now being requested. The weight of each service user is regularly recorded. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Both health care and personal support is provided in a manner preferred by the individual service user. Evidence: Service users have an individual section relating to health care integral to the individual care plan. An overview of their general health is completed, and acts as an indicator to possible changing health needs. Service users are supported with all aspects of their physical and emotional health, and receive adequate and appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dietitians. Information and advice is provided to all services users and any concerns are acted on with the consent of the service user. Service users are supported with personal care, dependent on a persons individual need and preference. This is clearly written in the care plan, with any difficulties or concerns clearly noted. Assessments and reviews are completed every three months, ensuring that the approach adopted is person centred and the agreed goals set, are meeting the persons needs. Assessments and reviews are completed every three Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: months, ensuring that the approach adopted is person centred and the agreed goals set, are meeting the persons needs. At times during the inspection tension between certain service users was observed. At one point a service user became upset by what another person had said. Whilst the staff member intervened and clearly new how to deal with individual patterns of behaviour, it again highlighted that in a small environment the importance in matching people carefully. When interviewed one service user said I am often unpleasant to them, but also I help her a lot. The staff member acknowledged that the relationship was strained at times but overall they did get on quite well. A medication storage and administration system is in place to which there have been no changes since the last inspection. The staff member had received training to administer medication as part of her induction. On the first day of the inspection one persons MAR (medication administration record) was not available for inspection. I was advised that this had been taken away by the manager. Concern was raised relating to recording, and the staff member stated that dosett boxes were packed by the local pharmacy each week and delivered to the home. However service users do not administer their own medication and therefore staff must be familiar with the medication that is being administered, and also that adequate recording is in place. The manager is a qualified nurse and carries out regular audits of this system, on a random basis. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure at the house is clearly written and displayed and service users can be assured that concerns and complaints will be listened to and acted on. Evidence: The complaints procedure was on display within the home. As part of the inspection the complaints log was examined, and no complaints have been made since the home opened in January 2008. Service users have regular contact with their allocated key worker, and concerns are addressed in the regular meetings. The manager stated in the AQAA that the staff are trained to pick up any traces of unhappiness and to deal with recording any complaint appropriately and passing it over to the manager. A verbal misunderstanding had occurred between a member of staff and a service user relating to the food menu. The manager had not logged this as it was verbal, and not written. Discussing with service users the complaints procedure as part of the inspection it was confirmed that they did appear to know how to make a complaint, and one person said the staff listen, and if not I can tell the manager. However all three people stated they would make a verbal complaint, and therefore the home should introduce the recording of verbal complaints to monitor possible trends. The manager stated that complaints and grumbles usually related to service users wanting to eat out. This sometimes related to what they had been use to prior to moving into the home. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: The home was not operational at the last inspection in January 2008.The homes safeguarding procedure has been updated since the last inspection and now includes guidance on reporting suspected abuse to the Local Authority. Training in the prevention of abuse is included in the induction programme, which was looked at, and discussed with the Manager. The staff spoken to was aware of how to use the homes procedures, and of the Whistle Blowing policy. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation is a safe well-maintained environment, which provides a number of shared spaces, but provides limited washing facilities to meet the needs of the current service users. Evidence: The house is a domestic style property which was seen to be clean and tidy on both days of the inspection. There is a lounge, a dining area adjacent to the kitchen, and a conservatory area which is mainly used by service users who smoke. Bedrooms are located on the first floor, and do not have en suite basins or toilets. The bathroom is located upstairs and the shower, bath and toilet is located together. There is a toilet facility downstairs but this is used mostly by staff. The staff member stated that there had never been a problem with the three service users sharing, and that the downstairs toilet was available to both staff and service users. There was an older male, and two women sharing the facility at the time of inspection. Both the women said that they did not like sharing the bath. One person said I shower, I would not like to sit in the bath. They are not my family. Another person said I dont use it very much, its a bit cold. The washing facilities in the house should be reviewed by the manager, to ensure service users have appropriate facilities to meet their needs, and that they are comfortable in sharing the current provision. Care Homes for Adults (18-65 years) Page 21 of 30 Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can be assured that sufficient staff are available to provide adequate support when they need it. Evidence: On the first day of the inspection one member of staff was on duty working with all three service users. The statement of purpose states clearly that two members of staff will be working in the home both in the morning and evening at all times. The member staff had been employed since July, a period of nine weeks. They had no previous paid employment in care. The member of staff showed a copy of the rota which showed the names of two staff on shift on most occasions. I was advised that due to training and sickness this situation had occurred. The service users who live in the home have a range of complex needs. One service user was observed to have an epileptic seizure, and although the staff member acted within the guidance of the persons care plan, it meant that the other two service users were provided with limited attention. Service users need to be risk assessed, and staffing levels required should be recorded. The statement of purpose should be changed to reflect the staffing levels. The staff team is small and several staff are new to care but have accessed a range of training including food hygiene, first aid, safeguarding and the administration of Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: medication. The staff member on duty stated that they felt supported as they usually worked with another member of staff, and that the manager had met regularly with them completing the induction checklist. Staff who are not N.V.Q qualified are supported to enroll as early as possible, as the manager stated that the service aims to have all staff qualified to N.V.Q level 2. Agency staff are not usually required as staff often are able to cover for each other. Staff from the agency were noted on the rota to be regular and new the service well. There is some concern that the information on the rota identifies that staff work long hours i.e. over a weekend the same member of staff maybe on duty. The staff interviewed said that this was by choice, and usually the second member of staff changed at each shift. The manager should monitor this practice and ensure the quality of support is not reduced or compromised by possible staff tiredness. Two new staff files were looked at as part of the inspection. The home has updated its policies and procedures for recruitment of staff. Employees do not start work until Pova and CRB checks have been received, and also two supporting references. Evidence was available to demonstrate that permanent staff are being regularly supervised, and the manager stated that this would be linked to the annual appraisal system. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is organised and managed in a way that enables service users to be part of the decision- making process whilst ensuring their care and safety. Evidence: The registered manager is a qualified nurse, and a high percentage of the current staff are N.V.Q qualified. This is the first inspection of the home being fully operational. The house currently accommodates three service users with a range of complex needs and is effective in ensuring that their changing needs are assessed and met. The overall standard of record keeping is good, which ensures service users receive a service that is consistent, and acknowledges their preferences. A random sample of health and safety documents were examined and these were up to date. The home had a completed fire risk assessment, which had been regularly updated, and there was evidence of fire drills and fire alarm tests. A sample of recorded financial transactions were looked at, and was found to be in Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: order with a robust system of checks and balances in place. Feedback from Service users and staff about the registered manager was positive with comments received about her being supportive and being part of the team. The Manager stated that the team is small and we all work together to provide a good level of support to the service users. This was echoed by the staff team, one person said the manager is available for guidance and support and their is a nice atmosphere between staff and service users. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Risk assessments should be completed with each service user to ensure adequate facilities are available for them to undertake personal care in a private and safe manner. For the safety and dignity of service users 31/03/2009 2 20 13 The registered manager must ensure that MAR (medication and administration records) are available to staff to sign and date when administering. For the protection and safety of service users. 28/02/2009 3 27 23 The registered manager should review the current facilities available for personal care i.e. toilets, wash basins, baths and showers. For the privacy and dignity of service users 31/03/2009 Care Homes for Adults (18-65 years) Page 28 of 30 4 33 18 The registered manager 28/02/2009 must ensure that the rota reflects the number of competent and experienced staff working in the house,as written in the statement of purpose. To ensure service users needs can be met. 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 The assessment process should be reviewed, and provide evidence that the assessment has considered the compatibility of the new prospective user with the people already living in the house, this will ensure service users social and emotional needs can be met. 2 22 A log/book should be available to record service users verbal complaints as this is the preferred method of reporting. Care Homes for Adults (18-65 years) Page 29 of 30 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. If you would like a summary in a different format or language please contact our helpline or go to our website. 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