Inspection on 30/10/08 for Intelligent Care

This inspection was carried out on 30th October 2008.

CSCI found this care home to be providing an Adequate 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

Intelligent Care 05/06/08

Intelligent Care 21/06/07

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: Intelligent Care 102 Park Road Bolton Lancashire BL1 4RQ     The quality rating for this care home is:   one star adequate 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: Michael Murphy     Date: 3 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 26 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 26 Information about the care home Name of care home: Address: Intelligent Care 102 Park Road Bolton Lancashire BL1 4RQ 01204386186 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Jamil Mohammed Mr Akeel Mohammed Type of registration: Number of places registered: Jamil Mohammed,Miss Nusat Khan care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following categories of service only. Care home only - code PC, To people of the following gender:- Either Whose primary care needs on admission to the home are within the following categories: - Mental disorder, excluding learning disability or dementia - Code MD The maximum number of people who can be accommodated is: 6 Date of last inspection Brief description of the care home Intelligent Care is a privately owned organisation that provides residential services in a care home called Queens Park View that is situated in a residential area of Bolton close to Bolton School. Queens Park View is a large three-storey Victorian style property with mature gardens to the front and back. The front of the property overlooks Queens Park which is a very popular landmark of Bolton with the home being located near to the town centre in a quiet residential road set back in an elevated position. The building Care Homes for Adults (18-65 years) Page 4 of 26 6 Over 65 0 Brief description of the care home has been fully refurbished with a large lounge, a further lounge/dining room and a kitchen. There are six bedrooms, two of which have en-suite facilities. The other bedrooms have washbasins with vanity units and all bedrooms have TV points. Toilets and showers are available on the ground and first floors. There is limited car parking to the front of the home and on street parking is also available. The Statement of Purpose says that the aim of Intelligent Care is to provide client centred rehabilitative care for people between 18 and 65 years of age who have mental health problems with the intention of enabling them to live independently or semi independently within the community. The home is currently registered for male and female service users. A Service User Guide, Statement of Purpose and a leaflet style brochure that describe the homes services is available in the home and the provider gives other information Care Homes for Adults (18-65 years) Page 5 of 26 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: one star adequate 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 1 stars. This means the people who use this service experience adequate quality outcomes. This inspection which included a site visit that the home did not know was going to take place was carried out over a seven hour period on the 30th of October 2008. The process of inspection included observing what went on in the home, talking to residents, staff, the home manager, looking around the home, and examining some important records. Care Homes for Adults (18-65 years) Page 6 of 26 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. 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 7 of 26 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 8 of 26 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. Existing residents living at the home had only been admitted following a full assessment of their care and support needs. This was important to ensure the home was suitable for them. Evidence: There have been no admissions to the home since the last key inspection in June/July 2008. At that inspection the pre-admission assessments of the six residents living at the home were inspected. Before residents were admitted to the home an assessment of their needs was carried out in consultation with the resident and their relatives by relevant health and social care professionals such as doctors (including psychiatrists, other mental health care workers and social workers). The home had conducted a pre-admission assessment on all residents. The reason for such an assessment was to help the prospective resident decide how appropriate living at the home would be and enable the person carrying out the assessment to determine if the home would be able to meet the prospective residents needs appropriately. The initial assessment helped to form the plan of care to be followed after admission to the Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: home. The six residents care records inspected at the last inspection contained detailed pre-admission assessments. Residents spoken to at the time of that inspection (five of who are still resident at the home) said they were actively supported by their care managers in the pre-admission process and that their views were important in the process. Trial visits to the home were regarded as an important part of the preadmission process and enabled prospective residents meet residents and staff at the home before a choice is made about entering the home more permanently. Care Homes for Adults (18-65 years) Page 10 of 26 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. The individual needs and choices of residents are recognised by the home and the manager and staff take appropriate action to support and help residents to lead an independent life as possible Evidence: The care records of four of the five residents were inspected on this occasion. All contained detailed care plans that had been developed as part of the management process. These care plans described the support and rehabilitaion needs of each resident and the way they needed to be helped to lead a fulfilling life in the community. Action has been taken by the home as required at the last inspection to develop care plans and assessments of risk that describe how individual residents are to be supported by staff to live as independent a life-style as possible in respect of life at the home. Discussion with the newly appointed mental health nurse who now works at the home revelaed that all care records were in the process of re-organisation and review. Detailed daily progress notes continue to be made and were dated, timed and Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: signed. Residents stated that staff continue to support them to lead as indipendeant a life as possible and treat them decently and with respect. Discussion with staff reflected that their ability to support residents in this way has significantly improved since the last inspection as staffing levels have increased. Staff were seen to have a good rapport with residents and interacted with them well. Residents are enabled to access the support and activities available from two local community mental health organisations and information about how to contact advocacy services for people with mental health needs was displayed in the home. Residents are encoraged to manage their own money and finances. Some are directly supported with this by the authority involved in their placement at the home. We were informed by the home manager that at the time of this inspection the personal allowances of only one resident were being managed at the home. The arrangements for this person appeared to be secure and appropriate and also to have been examined by this residents care manager at a recent review. The home manager informed us that no extra charges are made of residents in relation to their care and accommodation at the home. It is noted that the placement of each resident is subject to regular review by the relevant placing authority. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being encouraged and helped to participate in the local community and pursue leisure activities and live as independent life as possible. Evidence: Discussion with residents reflected that they were able to make personal choices in their daily lives and were encouraged and assisted by staff to do so. All residents go out on their own or accompanied by staff. At the last inspection there was an issue about such outings being limited at certain times by the number of staff on duty. As required at the last inspection action has been taken to address this. Discussion with residents and staff (as well as inspecting staffing provision and care records) revealed that residents were actively supported to access the local community and join in appropriate leisure activities. Residents stated they are encouraged and helped to maintain personal and family contacts if they wish. Residents and staff do not report Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: any unreasonable restrictions on residents being able to receive visitors at the home. Further discussion showed that the daily routines at the home and house rules aim to encourage independence. We have been informed the issue identified at the last inspection regarding residents accessing the lounge lounge and kitchen overnight has been resolved. This is due to alternative arrangements being made to accommodate the member of staff doing sleep in duty. Residents continue to report their privacy being respected and said that staff treated them in a kind way. General housekeeping in the home is shared between staff and residents. The domestic style kitchen and dining area were clean and appropriately equipped and furnished. A new floor covering had been layed in the dining area since the last inspection. Residents and staff were of the view that mealtimes were flexible and reasonable. Menus have been reviewed since the last inspection following consultation with residents. These were prominently displayed, reflected choice and were balanced. Residents said they could always have an alternative if desired. Food stocks were good and staff and residents do the food shopping locally. Residents and staff say there is always sufficient food and drink available. Cultural food preferences are catered for appropriately. The home manager informed us at the inspection that no extra charges are made in respect of food provision at the home. Each residents care file contains a record of meals they have had each day and their body weight is regularly monitored and recorded. Care Homes for Adults (18-65 years) Page 14 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst there have been improvements to how residents personal health care support needs are being met staff training in respect of medication needs to be developed further. This is to ensure that the care and support residents need is of as high a quality as possible. Evidence: Residents said that staff treated them decently, kindly and respected their dignity and privacy. The routine of daily life was said to be flexible and reasonable. The issues (identified at the last inspection) of residents accessing the lounge and kitchen area overnight have been resolved. Also staffing arrangements have now been improved to enable residents to be helped to pursue activities outside the home more often. Staff continue to support residents with their personal hygiene needs and evidence of this is written in their care records. All five residents were registered with a local GP and continue to be helped access specialist mental health services, chiropody, optical and other relevant health and social services. Each of the five residents has a care manager who has been appointed by the placing authority to support them and periodically review their placement at the home. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: As part of the inspection we looked at how residents medicines were handled by the home. We looked at the levels of medicines in the home, medicines records and spoke to the manager and staff about how residents are helped with their medicines. The way medicines are recorded has improved as was required at the last inspection. There is now a proper process in place that records what medicines come in to the home, when and how they are administered and what happens to medicines no longer needed. Medicines administration records are now printed and supplied by the chemist and had been completed appropriately by staff helping residents with their medicines. All these improvements help to make sure residents medicines are handled safely and appropriately. Two residents were looking after their own medicines to some extent. Both had been formally risk assessed (as required at the last inspection) and this had been recorded in their care records. We spoke with the home manager and the newly appointed mental health nurse about what training is being provided to staff about handling and administering residents medicines safely. Training packs have been obtained from an external training organization and the pharmacy that supplies the home. The mental health nurse said he is in the process of assessing the competence of all staff in this important area of supporting residents. We were also informed that it is intended to send all staff on medication training provided by the local authority training partnership. We are of the view that such training should be a priority. A system to regularly check medicines within the home has also been implemented since the last inspection. Medication policies and procedures have been produced and include a homely remedies policy as required at the last inspection. Storage of medicines was secure. The manager told us arrangements were in progress to obtain a suitable cabinet to store controlled medicines. Care Homes for Adults (18-65 years) Page 16 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements to listen to residents complaints have improved. However arrangements need to be made to ensure residents are being kept safe by staff who have all received appropriate and up to date safeguarding training. Evidence: Residents said they knew how to make a complaint if the felt it necessary. They said they would raise the issue with the home manager or their care manager. We were informed no complaints had been received by the home since the last inspection. Staff said they are aware of the importance of residents feeling safe and the importance of safeguarding them from being abused. The home has a safeguarding policy and also has a copy of the Bolton inter-agency safeguarding policy. The home has started to access Boltons local authority safeguarding training but this needs to be extended to all staff (including management) as soon as possible. The recruitment process operated by the home has been amended (as required at the last inspection) to ensure proper checks are made when employing staff. This is to help ensure that potentially vulnerable residents are being cared for and supported by suitable people. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides residents with a suitable and homely environment that is maintained to a good standard. Evidence: The home is suitable for its purpose and meets the needs of residents in a homely and comfortable way. All parts of the home were clean and free of any odours. The home is well furnished and decorated throughout. Each resident has their own bedroom. Three bedrooms were inspected at the last inspection and these were found to be clean, warm, suitably ventilated, comfortably/appropriately furnished and personalised. Residents continue to express satisfaction with their rooms and say staff respect their privacy. WC and shower rooms were clean, suitably equipped and provided privacy. The lounge has been redecorated since the last inspection and a new floor covering has been provided. We have been informed by the manager that the issues identified at the last inspection relating to residents access to the lounge overnight have been resolved. Residents who wish to smoke are permitted to do so in the patio area to the rear of the home. Care Homes for Adults (18-65 years) Page 18 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the arrangements to recruit and provide staff have improved and some improvements have been made in respect of staff training further improvements in this area need to be made. This is important because residents individual and joint needs should be met by appropriately trained staff. Evidence: The staffing rotas for August, September and October 2008 were seen. At the time of this inspection there were five residents living at the home. As required at the last inspection in July 2008 action has been taken to ensure that adequate staff are on duty to support residents. Staffing rotas clearly identified the member of staff who was to provide the night duty sleep in cover. Discussion with residents and staff revealed that residents were now more actively supported to access the local community and join in appropriate leisure activities. The general view is that this is due to better staffing levels and the presence of a home manager. We were informed by the one of the homes owners (who is also the manager) that the member of staff who provides night cover uses a vacant bedroom. However he was planning to make more permanent provision elsewhere in the home. This should permanently resolve the issue that was identified at the last inspection regarding residents accessing the lounge overnight. Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: The staffing rota identifies who the senior person on call is to provide support in case of emergency. As required the recruitment process at the home has been improved since the last inspection. The recruitment files of two staff employed at the home since July 2008 were inspected. These contained evidence of police checks and another special check regarding suitability to work with vulnerable adults. Whilst there have been improvements in staff training this still needs to be developed further. A plan of training had been drawn up for 2008 to 2009. This details the training to be delivered to individual staff. Although training about safeguarding, medication awareness and other important areas has been provided to some staff this needs to be extended to all staff working at the home. It is acknowledged that the home has engaged an external trainer however it is strongly recommended that staff are also enabled to access the training provided by the local authority partnership. The majority of the training provided to staff relates to providing care and support to people in care homes. Whilst this is valuable and relevant this needs to be supplemented at Intelligent Care by staff training about supporting people with mental health issues. The newly employed mental health nurse informs us that training of staff is one of his priorities in his role. He was in the process of developing a personal development plan for each member of staff. Care Homes for Adults (18-65 years) Page 20 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the management arrangements at the home have improved the manager needs to further develop staff training to ensure residents individual and joint needs should be met by appropriately trained staff. Evidence: There have been improvements of how the home is managed. One of the home owners has become the full-time manager of the service and at the time of inspection was seeking registartion with the CSCI. Consequently both residents and staff are benefitting from the leadership that was identified as lacking at the last inspection in July 2008. Action has been taken by the manager to address the eleven requirements made at that inspection and this is recognized by us. However the provision of staff training at the home needs to be developed further as described in this report. This is a key responsibility of the home manager. This was discussed in detail with the manager and the newly appointed mental health nurse (who is going to be involved in supporting staff with their training needs - particularly in respect to supporting residents with mental health needs). The manager has introduced ways to assess the Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: quality of the service provided to residents. He has started to make checks on how well various aspects of the home are doing. For example regular checks on care records, medicines, food provision and the environment have been introduced. Meetings are held between residents and staff where any issues are aired and actions agreed. Both residents and staff felt these meetings were useful and enabled everybody to express their views and get things done. As required at the last inspection action has been taken to improve fire safety prevention in the home. The manager has conducted a fire safety risk assessment of the home and is ensuring fire safety checks are completed and recorded. Care Homes for Adults (18-65 years) Page 22 of 26 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 23 of 26 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 20 18 That the CSCI is informed in writing what arrangements have been made to provide all care staff with safe handling of medicines training To ensure residents are protected by staff who are competent in the safe handling of medicines within the home. 13/01/2009 2 20 13 That the CSCI is informed in writing what progress has been made obtaining a suitable cabinet for the storage of controlled medicines in the home. To ensure medicines are securely stored in the home. 13/01/2009 3 23 13 That The CSCI is informed in 13/01/2009 writing what arrangements have been made to provide all staff working at the home with safeguarding training. Care Homes for Adults (18-65 years) Page 24 of 26 To ensure residents are kept safe whilst being cared for and supported at the home. 4 35 18 That the CSCI is informed in writing what specific arrangements have been made to provide staff (including the manager) with appropriate training to fulfill their role (particularly in relation to supporting the mental health needs of residents. To ensure residents are being cared for and supported by competent staff 13/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 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. 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