Inspection on 10/10/08 for Fernwood

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fernwood 28/11/06

Fernwood 01/11/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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: Fernwood 30 Fern Road St Leonards-On-Sea East Sussex TN38 0UH     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 Davies     Date: 1 0 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 30 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 30 Information about the care home Name of care home: Address: Fernwood 30 Fern Road St Leonards-On-Sea East Sussex TN38 0UH 01424460689 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Graham Robert Jack care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Learning Disability (LD) not falling under any other category. The maximum number of service users to be accommodated must not exceed three (3). The people accommodated will be between the ages of eighteen (18) and sixty five (65) years of age on admission Date of last inspection Brief description of the care home FERNWOOD IS A LARGE DETACHED PROPERTY IN A QUIET SUBURBAN AREA OF ST LEONARDS. THE HOME HAS AN ACCESSIBLE AND LARGE BACK GARDEN. THE FRONT ENTRANCE TO THE HOME WOULD BE UNSUITABLE FOR WHEELCHAIR USERS. THE HOME HAS ONE BATHROOM AND ONE SHOWER ROOM/TOILET. ALL ROOMS INCLUDING THE KITCHEN, DINING ROOM, LOUNGE, AND BEDROOMS ARE LARGE AND SPACIOUS. THE HOME IS MODERN AND WELL APPOINTED. THE HOME IS CLOSE TO LOCAL TRANSPORT LINKS. EACH ROOM HAS SINK WITH A TOILET AND A CHOICE OF TWO BATHROOMS NEAR TO BEDROOMS. THE HOME IS REGISTERED TO PROVIDE SERVICES FOR UP TO 3 YOUNGER PEOPLE WITH A LEARNING DISABILITY. THE OWNER/ MANAGER OF THE HOME MR GRAHAM JACK OWNS A SIMILAR TYPE OF HOME Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 3 Brief description of the care home IN HASTINGS. Information on the range of fees charged is within the homes current statement of purpose/service user guide and ranges from #930 to #1630 per week. Charge?s for extras includes personal items such as toiletries and clothes, part of the basic cost of annual holidays, and hairdressing. All Service Users have some kind of advocacy to assist the management of financial affairs. Inspection reports are not routinely sent out to families and advocates after each publication although a copy is kept on display in the reception area of the home and can be obtained via the manager. A service user guide containing the most recent inspection report is sent to any interested person [or their representatives] looking to move into the home. 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: This key unannounced inspection was carried out on the 10th October 2008, over a period of six hours. During the inspection the inspector spoke with the service users, staff and registered provider manager. An audit of medication was carried out. The inspector carried out a tour of the premises and garden, which included communal areas, bathrooms and toilets and two residents bedrooms. Documentation relating to the key standards inspected was looked at together with information included in the Annual Quality Assurance Assessment provided to The Commission by the home. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Where individual care plans state the goals which service users wish to work towards, there is no detailed report as to what progress is being made towards meeting these goals, neither does it show what goals have been met, and what aspirations service users have for meeting new goals. Care Homes for Adults (18-65 years) Page 8 of 30 While the administration of medication is good in the home, there is no guidance for staff in regard to PRN (when required) medication. This guidance should state how staff can recognise when a PRN (when required) medication is needed for a service user, and give good guidelines in regard to administration and recording. All staff need to undergo infection control training, to ensure that they are aware how to reduce the risk of infection and what steps they should take if infection breaks out. The quality assurance system while improved since the last key inspection must seek to obtain the views of external professionals who visit the home. When employing new members of staff the registered provider/manager must ensure that he seeks a full employment history and that there is good written explanation of any gaps in employment. 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 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. Prospective service users are given the information they need, to enable them to make an informed choice about moving into the home. Prospective service users needs are assessed prior to moving into the home, to ensure that the home can meet their needs. Evidence: The statement of purpose and service users guide has been updated to reflect all the service users presently residing in Fernwood. From evidence obtained from service user care plans, each service user received a thorough assessment of their needs prior to moving into the home, and the registered provider manager also obtained pre-admission assessments from the funding local authority and other health care professionals involved with the service user. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Each service user was invited to visit the home prior to taking up residence in the home. 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 know that their assessed needs and future goals are reflect in their care plans. All service user in the home are able to make decisions about their lives and are given assistance by the staff as and when needed. Service users are supported in taking risks by the staff in the home. Evidence: The three care plans were viewed for the three residents living in the home. All care plans were very individual to the service users and were based upon the pre-admission assessments. Care plans contained details of every aspect of the service users lives and clearly described service user goals for the future. The inspector did note that while service users are given all the help and assistance by the registered provider/manager and staff in the home, more could be done to record how far the Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: service user is progressing to-wards achieving their goal/s and where goals have been achieved what further goals have been chosen by the resident to achieve. In Fernwood the service users are given every opportunity to make decisions in relation to their everyday lives. The staff in the home have a good understanding of how to communicate with each service user. Service users have the opportunity to go shopping with the staff, and are able to make choices in regard to the food purchased for the home. Each service users care plan contained individual risk assessments, relating to their personal, physical and social care. These risk assessments give clear guidelines to staff as to how the levels of risk could be kept to minimum for the service users. Service user care plans are kept securely and confidentially in the home. Through conversation with staff it was evident that they understood service user confidentiality and how to recognise when their would be a need to share confidences with other health or social care professionals. 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. Service users are encouraged to take part in activities that are of interest to them and staff support them to do this. Service users are well integrated into the local community and maintain friendly contact with local neighbours. Service users are able to maintain links with their families. Food in the home is good, giving service users a good health and balanced menu. Evidence: All three service users have severe forms of learning disability and are therefore not Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: able to participate in education or paid employment. Staff ensure that one service user is able to attend a local day centre Monday to Friday. Another service user enjoys swimming, horse riding and visiting the Decoder Centre one day a week. All service users have good links with the community and are encouraged to help staff with shopping. Support from local neighbours is good and service users are invited into neighbourhood homes from time to time. The home has its own form of transport and service users are able to go out when they choose to. There was good evidence both within care plans and daily reports that service users are able to maintain links with their families and friends. On the day of this inspection one service users was going to spend a weekend with his mother and another service user spends frequent weekends with his relatives. Staff reported that one service user who has no family support was able to bring a friend from the day centre home with him for tea. Visitors are always welcomed into the home. The daily routines of the home fit around the service users interests and community activities. It was observed that staff respect the service users rights to privacy and dignity, and always knock on bedroom doors prior to entering. All personal care is carried out in the privacy of the clients bedroom or bathroom. Staff do not open service users mail unless permissions have been sort. It was noted for one service user that their mother had given permission for staff to open her sons mail. Service users have unrestricted access to a safe and secure garden and to most parts of the home with exception of other service users bedrooms. While there are formal menus in the home, service users in the main part are able to choose their meals on a daily basis. Service users are also encouraged to go and shop with staff, so that they may choose what they would like to eat. Staff working at the home stated that they always encourage service users to eat a healthy and nutritious diet. One service user is on a high carbohydrate diet for a health problem, and staff ensure that his dietary needs are met, this has resulted in this service user gaining weight since living in Fernwood. Two service users are able to access the kitchen as and when they want to prepare a light snack or to make a drink. Another service user needs one to one staff supervision when in the kitchen. 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. Service users receive personal support according to their wishes. Service users physical and emotional needs are met with clear guidelines for staff to follow. Medication is well manged within the home and promotes the health of the service users. Evidence: Each care plan has personal care guidelines which clearly indicate to staff when and how the service users prefer to bathe and what tasks staff need to assist with. For example one service user prefers to bathe in the morning, and staff respect his wishes. All health care needs are stated within each service users care plan. For example specialised diets, regular visits to the dentist. One care plan also has guidelines for relieving a service users anxiety and another explains to staff how to reduce levels of Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: aggressive behaviour. There was evidence within the care plans and daily reports that service users have access to health care specialist as an when required, including regular visits to consultants at the local hospital. An audit was carried out of medication in the home, it was noted that a minimal amount of medication is used. The registered provider/manager explained that service users regularly have their medication reviewed and this is kept to a minimum by the service users general practitioners. It was noted that all Monthly Administration Records are completed accurately. The Monthly Administration Records are separated by dividers which have a photograph of the service user and give staff clear instructions and include any allergies. All staff have received medication training. The home uses a monthly blister packed medication. There is minimal stock of medication. The medication policy and procedure gives clear guidelines to staff. Discussion took place with the registered provider/manager as to how this medication policy should included clear guidelines for staff in regard to PRN (as required) medication. One service user has been prescribed a PRN medication, which he does not take very often, but there are no clear guidelines for staff to follow as to when this medication should be administered. The home does not use controlled drugs, but there is suitable storage should controlled drugs need to be used. All medication is locked away in an appropriate medication cupboard, to which only the staff have access. 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 views of service users and their relatives are listened to and acted upon. Staff have a good knowledge of safeguarding vulnerable adults and helps service users from being abused. Evidence: The inspector viewed the complaints policy and procedure and found it to be up to date. All three service users have a pictorial complaints policy and procedure within the care plans. A staff member stated that a resident would need one to one assistance from a member of staff should they need to complain. There have been no complaints made to the home since the last key inspection. The complaints file was viewed and contained evidence of one complaint made prior to the last key inspection and this was seen to be properly investigated and recorded, with a timely reply made to the complainant. The home has up to date policies and procedures for the safeguarding of vulnerable adults and whistle blowing. There have been no safeguarding vulnerable adult alerts since the last key inspection. Staff have a good knowledge of safeguarding vulnerable adults and staff on duty stated that they had received Protection of Vulnerable Adult training. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Staff are appropriately recruited to work in the home with all checks being carried out prior to a new member of staff being employed. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a homely, comfortable and safe environment. The home is clean and hygienic throughout and there is no risk to service users. Evidence: Fernwood is a well presented chalet bungalow in a residential area. Spacious accommodation is provided throughout the home. All rooms are decorated and furnished to a high standard and are domestic in style, providing a comfortable and homely conditions for the service users. No health and safety hazards were seen on the day of this inspection. The back garden is large and well tended, safe and secure for residents use. The back of the garden is securely fenced with a chain link fence, which is mostly obscured by hedging and trees, but there is a small gap, where service users can observe wildlife in a conservation area. Service users bedrooms are decorated to a high standard, with good quality furniture and soft furnishings. Service users are encouraged to personalise their own bedrooms. One bedroom was tastefully decorated to reflect the service users support for a football club. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The whole of the premises is kept in a clean and hygienic condition and there were no offensive odours on the day of this inspection. Laundry facilities are fitted into the large spacious kitchen. Service users laundry is washed when no food is being prepared in the kitchen. Staff have a good understanding of infection control procedures but none have received infection control training. This was discussed with the registered provider manager who will investigate what infection control training is on offer. 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 are supported by a competent and qualified staff team. Service users are supported and protected by the homes recruitment policy and practices. Staff training needs some improvement to ensure that staff have up to date knowledge. Service users benefit from well supported and supervised staff. Evidence: The staff rota showed that there were sufficient staff on day duty to meet the needs of the service users, especially one service user who needs one to one supervision during the day. There is always one night carer to meet the service users needs at night. Recently two members of staff have left the home for personal reasons. The registered manager is in the process of recruiting two more staff, and a service users parent will sit in on the interviews. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Half of the staff presently employed at the home have achieved their NVQ qualification in Social Care. Staff spoken to on the day of the inspection showed a good knowledge of the service users needs and how they could meet their individual needs. This was also observed through different styles of communication with the two service users in the home during the inspection. The registered provider/manager carries out stringent recruitment practices and ensures that all prospective staff have POVA first and CRB checks carried out prior to employment and that two written references are also obtained. Staff files viewed showed that each file has an application form and two forms of identification. It was noted that the application form does not request a full employment history and this was pointed out to the registered provider/manager. From viewing staff training certificates it was found that staff have completed nearly all their mandatory training with the exception of infection control. The inspector noted that some mandatory training needed to be re-addressed as staff had received it more than two years ago. Each staff file had evidence that staff had received formal supervision at least six times per year. 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. Service users benefit from a well run home. The quality assurance system in the home needs to be developed further to ensure that the best quality of service is offered to service users. Working practices in the home are good ensuring that service users and staff live and work in a safe environment. Evidence: The registered provider/manager has completed his NVQ level 4 and Registered Managers Award, he is also a registered learning disability nurse and has many years experience of working with learning disabilities. Staff spoke highly of the registered provider/manager saying that he was dedicated to the service users. Staff find him to be highly motivated and fair. The registered provider/manager often works hands on with the staff. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: The home does have a quality assurance system in place, which seeks the views of service users (with help from the staff), and relatives. The registered provider/manager has developed an annual development plan and health and safety and fire risk assessments. This quality assurance system needs to be developed further to seek the views of stakeholders which should include all health care professionals, and other professional visitors to the home. Regular weekly checks are carried out of the fire alarm system and hot water temperatures within the home. All equipments used in the home has current maintenance certificates. Any accidents or illnesses are reported in a timely manner to the appropriate authorities. All service users accidents are recorded in an Environmental Health Executive accident book in an appropriate way. The health and safety policies and procedures are up to date and give staff good guidelines to ensure they are working in a safe environment. New staff also received induction training which covers health and safety issues in the home. 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 34 19 The registered person shall 15/12/2008 not employ a person to work at the care home unless (b) subject to paragraphs (6), (8) and (9), he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. The registered provider/manager must ensure that he obtains a full employment history for any prospective employee. 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 6 Where service users have chosen to meet goals in the daily lives and these are recorded in their care plan. There should be some evidence as to the progress that service user are making in meeting these goals. Where goals have been met further goals should be evidenced and planning put in place as to how these goals are going to be achieved. Page 28 of 30 Care Homes for Adults (18-65 years) 2 3 4 20 30 35 It is good practice to ensure that staff have a policy and procedure in place for PRN (as required) medication. The registered provider/manager must access infection control training for staff. Mandatory training should be reviewed each year with the exception of First Aid and Food Hygiene. Therefore moving and handling, medication training needs to be arranged for staff to update their skills and knowledge. The quality assurance system needs to be developed further to ensure that views of all visiting professionals to the home is sort. 5 39 Care Homes for Adults (18-65 years) Page 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!