Inspection on 09/10/08 for Greene House

This inspection was carried out on 9th 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

Greene House 16/10/06

Greene House 31/01/06

Greene House 28/09/05

Greene House 02/03/05

Greene House 24/09/04

Greene House 25/02/04

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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: Greene House The National Society For Epilepsy Chesham Lane Chalfont St Peter Gerrards Cross Bucks SL9 ORJ     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: Joan Browne     Date: 0 9 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: Greene House Chesham Lane The National Society For Epilepsy Chalfont St Peter Gerrards Cross Bucks SL9 ORJ 01494601426 01494871927 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Andrew Anderson Type of registration: Number of places registered: The National Society for Epilepsy care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: That as of the 1st of April 2006, in relation to the variation submitted to CSCI, the home`s registration is varied to allow for the admission of one service user with Dementia. That this condition relates to a single service user, and should they leave the home, for whatever reason, the home must notify CSCI and this condition will cease to apply. Date of last inspection Brief description of the care home Greene House is a care home registered to provide care, support and accommodation for up to 17 people with learning and physical disabilities. The home is part of the National Society for Epilepsys campus in Chalfont St Peter and constitutes a detached building offering single room accommodation to all service users. There is ample communal space as the home is divided into five groups. Externally there are Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 18 18 Brief description of the care home communal grounds of the campus. Service users are able to access the nearby towns of Amersham, Slough and High Wycombe although public transport links are restricted. The village of Chalfont St Peter has some amenities and there is a shop and a restaurant on campus. 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 unannounced site visit, which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection (CSCI) was undertaken by Joan Browne on 9 October 2008 and lasted for approximate seven and a half hours. The last key inspection on this service was completed on 16 October 2006. The CSCI Inspecting for Better Lives (IBL) involves an annual quality assurance assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps us to prioritise the order of the inspection process and is referred to in the report. The information contained in this report was gathered mainly from records kept at the Care Homes for Adults (18-65 years) Page 6 of 30 service and information contained within the AQAA. We also looked at care plan documentation, staff recruitment files, training records, medication documentation and health and safety records. A tour of the premises was conducted. Comment cards were sent to the home to be distributed to people using the service, health care professionals and staff members. Their comments have been reflected into the report. Four requirements and four recommendations of good practice were issued on this visit. Please see environment outcome, concerns complaints and protection outcome and conduct and management of the home outcome for full disclosure. Feedback was given to the manager at the end of the inspection. The current weekly charges for this service range from 883.00 pounds to 1650.00 pounds. We (The Commission) would like to thank all staff and people using the service who made the visit so productive and pleasant on the day. What the care home does well: What has improved since the last inspection? What they could do better: Staff need to ensure that money kept in the home for people using the service does not exceed the organisations 30.00 pounds limit. To ensure that maintenance issues identified in this report are actioned so that the environment is appropriately maintained and is safe for people to live in. Care Homes for Adults (18-65 years) Page 8 of 30 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. The home ensures that peoples diverse needs are assessed prior to providing a service. Evidence: Pre admission information was looked at relating to new service users recently admitted to the home from another service on site. A detailed assessment of individuals needs was undertaken by the manager including history of epilepsy. Arrangements were made for the two individuals to visit the home several times prior to their admission. Evidence of visits undertaken were seen along with transition diaries. The two service users said that the assessment process was carried out sensitively by the homes staff. They confirmed that a member of staff was allocated to them to assist them with understanding how the home was organised. This staff member is now their key worker. The home aims to ensure that contracts are issued to new service users outlining what the service provides. Care Homes for Adults (18-65 years) Page 11 of 30 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. People using the service are involved in the decisions about their lives and are enabled by staff to take risks and to maintain their independence. Evidence: Three care plans were examined for the service users whose care was case tracked. Plans contained detailed information also a guide on what assistance individuals required and a summary of their goals and the suppport mechanisms in place to help individuals to achieve their goals. The annual quality assurance assessment (AQAA) stated that the home was currently piloting a new care plan format which was more accessible to the service users and more user friendly. Evidence of the new care plan was seen. We were told that some service users did not like the new care plan format and preferred to contine using the old care plan. Service users spoken to said that they were involved in making decisions and this was evidenced by information recorded in care plans and minutes of monthly service users Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: meetings. A number of service users had been issued with keys for their bedrooms and the front door. Staff spoken to were able to demonstrate how service users were making choices. For example, a number of individuals were being supported to manage their own medication wallets and self-administering their medication. There was a recent wedding ceremony for two service users, which was arranged by the staff team and their relatives. We were told that a number of service users were managing their own finances. Arrangements were being made for one particular service user to apply for a bank card. Some service users continue to be supported by the staff team with their finances with the appropriate risk assessment in place. Examination of financial record sheets for two service users indicated that money held tallied with the balance sheets. We noted that the organistions financial policy stated that no more than 30.00 pounds should be kept in the home for individuals. The policy was not being adhered to because the balances on the two service users money exceeded the 30.00 pounds limit. It is recommended that staff comply with the organisations policy to ensure that service users money is protected. 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. People said that staff treated them as an individual and enabled them to make choices and decisions in how they wish to live their lives. Evidence: The annual quality assurance assessment (AQAA) stated that service users are encouraged by staff to participate in community activities and where ever possible to leave the NSE site and live in the community if that is their wish. We were told that several service users were engaged in further education learining such as literacy, numeracy, information technology and sewing. The service was currently caring for three service users with a view of enabling them to be independent and to move into the community if they wished to. Two of the service users were spoken to and they confirmed that they participate in age, peer and culturally appropriate activities. However, they said that the lack of transport facilities at times restricted them to enjoy Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: activities in the wider community. It would be useful if senior management could explore the possibility of the home acquiring its own transportation to enhance the outside activities for service users. We were also told that some service users work on site doing light assembly work and gardening. Staff spoken to expressed their frustration by not being able to accommodate service users wishes at short notice especially at weekends to participate in outside activities. Wherever possible service users are supported by staff to maintain their independence. Those service users living in the independent unit have delegated responsibilities and are fully responsible for keeping the unit clean and looking after their personal laundry and cooking with staff support. We were told that all the service users had been on holiday abroad or in this country. Arrangements were made for some service users to have a holiday near to where some of their family members were living. We observed staff respecting service users privacy and dignity and talking and interacting with them in a respectful manner. The home has become self-catering and all meals are prepared by staff. Service users said that they are consulted about menu choices and the meals prepared were tasty and plentiful. We observed fresh fruits and flowers in the house, which meant that people were able to help themselves to fruits if they wished to. A requirement was made at the previous inspection to ensure that the food temperature reaches at least 70 degrees celsius to prevent a food poisoning risk. Examination of food temperature records indicated that they were within the normal range. 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. The home ensures that staff support people with their personal and health care needs in a sensitive manner and in the way they prefer and want. Evidence: Care plans examined provided a good description of service users personal support needs and what they are able to undertake for themselves. Evidence was seen in files of the involvement of other health care professionals input such as, the neurologist, epileptic and first line nurse. Health care professionals who responded to the Commissions survey said that staff do as much as they can within their limitations to support service users with their needs. We spoke to a health care professional during our site visit and the individual commented that staff were knowledgeable about service users needs and would always seek advice when necessary. Staff confirmed that service users attend routine health screening appointments such as dental and optical checks. It is pleasing to report that these appointments are now being recored in individualss care plans. Medication records seen indicated that service users medication was being Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: appropriately managed. Several service users were self-medicating their own medication with minimal assistance from the staff. Records were in place to verify that staff check that the wallets were being filled appropriately by individuals. We were told that medication cupboards had been fitted in some service users bedrooms to ensure their privacy and safety. There was a clear audit trail in place of all medication entering and leaving the home. 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 home has a complaints and safeguarding policy in place to ensure that people are able to express their concerns and are protected from abuse and have their rights protected. Evidence: The home has a complaints procedure. Information in the annual quality assurance assessment stated that all service users had been issued with a copy of the homes complaints procedure. We observed that a copy of the complaints procedure was on display in the front entrance of the home. People who responded to the Commissions survey said that they were aware of how to make a complaint. No information regarding complaints made to the service by service users or their representative has been received by the Commission. However, the homes complaints folder reflected that the service had received one complaint since the last inspection, which was satisfactorily investigated. Adult protection and whistle blowing procedures were in place. Some staff spoken to said that they regularly undertake updated training in the protection and safeguarding of vulnerable adults. Dates of planned training for staff in the safeguarding of vulnerable adults were displayed in the office. The Commission was made aware of a safeguarding Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: incident which was satisfactorily investigated by the police and the matter has now been closed. The home has a flow chart to assist staff on how to report safeguarding incidents. We observed that the telephone number for the Commission was not correct. It is recommended that the chart is amended to reflect the Commissions correct telephone number. A requirement was made at the previous inspection for service users to be offered awareness raising on adult protection. It is pleasing to report that the requirement had been complied with. 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. Effort has been made by staff to create a safe, homely and comfortable place for people to live within the constraints of an old and listed property. Evidence: Greene house is a detached property divided into small living groups with a communal lounge and kitchen. Service users accommodation is situated on the ground floor. Since the last key inspection the home has developed an area of the home for three service users to support them to be independent and to develop daily living skills. All areas of the home were bright, and clean. Effort had been made to add homely touches such as the display of pictures, fresh flowers and fruit. At the front of the building there is a large fish tank which creates a homely and relaxing environment. All bedrooms in the house are single occupancy. Those viewed looked personalied with family pictures and mementoes. Staff have tried to make the toilets, bathroom and shower areas to look homely but because of lack of ventilation the walls and ceilings appeared damp and covered in mildew. The paintwork on the walls and radiators were peeling and floor coverings were stained and in need of replacing. The toilet bowl in the three-bedded unit was badly stained and needed to be replaced. We observed that the bulbs in the Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: ceiling lights in areas of the building needed replacing. Evidence was seen in maintenance records that staff had requested for bulbs to be replaced but no action had been taken. We also observed that a draw in the main kitchen was broken and needed to be repaired as well as the door on the wall unit in the dining room. A requirement is made in this report for maintenance issues to be addressed. 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. Staff working in the home are provided with sufficient training to enable them to care for people using the service and to support the smooth running of the service. Evidence: The home aims to ensure that four members of staff are rostered to work on each shift to meet service users current needs. The shifts appeared to be well organised with a handover between the moring and afternoon staff. The staffing arrangements at nights have been reviewed and there is now one waking night staff and a sleep in person. Staff who responded to the Commissions survey said that sometimes the home experience staff shortages especially when staff members are sick or bank staff fail to turn up for duty. We were told by the manager that there were some vacant positions and interviews were taking place shortly to recruit to the vacant positions. Evidence was seen to indicate that regular monthly staff meetings are held with a range of topics and issues discussed between the team. Examination of the recruitment records for the two staff employed since the last inspection reflected that thorough recruitment processses had been followed with all the necessary checks undertaken and original documentation available at the human resource office on site. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Training records seen demonstrated that mandatory training is well managed. Staff were up to date or booked to attend refresher training. In the office there was a list of training dates for updated training taking place between October 2008 and January 2009 for the following topics: fire awareness, safeguarding of vulnerable adults, infection control, challenging behaviour and medication. We were told that nine of the twelve care staff had achieved the national vocational qualification (NVQ) in direct care at level 2. This mean that the home had achieved the 50 target. The manager told us that in addition to the mandatory training regular quarterly in-house training is held. Evidence of training and topics discussed was made available for the inspection purpose. Staff who responded to the Commissions survey said that there was a good training programme in place. 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 run and managed appropriately, which should ensure that people using the service and staff safety is promoted. Evidence: The home is managed by an experience and innovative manager. He holds the registered managers awards and the national vocational qualification (NVQ) level 4 in care. Staff and health care professionals who responded to the Commissions survey were complimentary about the managers leadership skills and his determination to ensure that people using the service receive a quality service. The manager is supported by three team leaders and care workers. The deputy managers position was currently vacant. The manager was complimentary about the staff team and had confidence in the service they were providing to service users. The manager was able to demonstrate how he updates his knowledge and skills by networking with other managers, attending training courses and management forums. Evidence was seen of reports from regular monitoring visits undertaken on behalf of Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: the provider. The manager regularly sends out surveys to service users, relatives and health care professionals to seek their views about the service. We were told that twenty-one people responded to the surveys and twelve people rated the service eight of ten. A range of health and safety checks is undertaken. For example, the fire panel and emergency lighting were being checked daily and this is deemed as good practice. Evidence of regular fire drills taking place was seen. A recommendation was made at the previous inspection to ensure that records contain date and time of drill, who was present (both service users and staff), how long it took to evacuate the premises and any issues such as service users not responding or people taking an unnecessaily long route out of the building. The home has acted on the recommendation and now has a supplementary record sheet of most of the information mentioned. However, it does not include the names of staff members and service users. It is recommended that the fire drill supplementary records are reviewed to include the names of staff and service users. A requirement was made at the previous inspection for an updated generic risk assessment to be prepared for the premises. It is pleasing to report that the requirement has been complied with. There were records in place to demonstrate that hot water temperatures are regularly monitored to ensure that they are within the appropriate range. We observed that staff practice was not always consistent to ensure that opened bottles of sauces and food were labelled and dated so that they are used within the recommended time scale after being opened. A recommendation is made to ensure that opened packets of food and sauces are dated and labelled so that they are used within the recommended time scale once opened. 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 24 23 The broken draw in the 23/11/2008 kitchen and the broken door on the wall unit in the dining room must be repaired. To ensure that people live in a home that is appropriately maintained to promote their safety. 2 24 23 Flaking paint on walls and radiators in the bathroom and shower area must be remedied. To ensure that people live in a home that is appropriately maintained. 22/11/2008 3 24 23 Arrangements must be made for the mildew stains on the ceilings and walls in the bathroom and shower area to be investigated and remedied To ensure that people live in a home that is appropriately maintained to promote their safety 22/11/2008 Care Homes for Adults (18-65 years) Page 28 of 30 4 24 23 The stained toilet bowl in the 23/11/2008 3 bedded unit must be replaced. To ensure that people live in a home that is appropriately maintained to promote their safety. 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 7 Staff should comply with the organisations financial policy and make sure that money held in the home for people using the service does not exceed the financial limit. The telephone number for the Commission that is recorded on the homes safeguarding flow chart should be amended to reflect the Commissions correct number. Opened bottles of sauces should be labelled and dated to ensure that they are used within the use by timescale. 2 23 3 42 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). 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