Inspection on 27/02/09 for Lee Road (9-11)

This inspection was carried out on 27th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lee Road (9-11) 25/06/07

Lee Road (9-11) 05/04/06

Lee Road (9-11) 16/01/06

Lee Road (9-11) 29/07/05

Lee Road (9-11) 17/03/05

Lee Road (9-11) 12/08/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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: Lee Road (9-11) Southcourt Aylesbury Bucks HP21 8JF     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: Chris Schwarz     Date: 2 7 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Lee Road (9-11) Southcourt Aylesbury Bucks HP21 8JF 01296483997 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Royal Mencap Society care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registred person may provide the following category/ies of service only: Care home only - PC To service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home 9-11 Lee Road is registered for the care of six service users with learning disabilities. It is situated amongst a residential estate in Aylesbury and is a short bus ride away from the town centre. All bedrooms are single with one providing en-suite facilities. There is a lounge and a dining area that are adequately sized for the numbers of service users for which the home is registered. A homely domestic environment is provided. There is a large, enclosed garden at the back and parking in the drive and on the road. The home has ramped access with grab rails to the front and rear. The home has easy Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home access to community facilities, including doctors surgeries, shops, pubs, a library and leisure facilities. Care Homes for Adults (18-65 years) Page 5 of 29 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 key inspection was conducted by Chris Schwarz over the course of a day and covered all of the key National Minimum Standards for younger adults. The last key inspection of the service took place on 25th June 2007. Prior to the inspection, a detailed self-assessment questionnaire was sent to the manager for completion and the findings used as part of the inspection planning and overall assessment. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the manager and other staff, opportunities to meet with people using the service, examination of some of the homes required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Care Homes for Adults (18-65 years) Page 6 of 29 The manager, staff and people who use the service are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well: What has improved since the last inspection? What they could do better: Assessment of prospective users needs to be undertaken by a person with suitable experience and skill to do so and must provide a detailed and accurate account of peoples care needs in order that an informed decision can be made on peoples suitability to live at the service. The service users guide and statement of purpose need to be updated and produced in formats accessible to people using the service so that they have information readily to hand about what the service can provide. Dental appointments need to be made for people using the service where they have not received recent check ups, to make sure that their health care needs are fully met. The environment needs to be improved through attention to the windows and the path by the back door and tidying up of the garden, to keep the premises in a well maintained condition. Health and safety needs to be improved by obtaining up to date gas safety and electrical hard wiring certificates, to make sure that people are not being placed at risk from harm. Care Homes for Adults (18-65 years) Page 8 of 29 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 29 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 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessment of the most recently admitted person had not been undertaken to a satisfactory standard and was not sufficient to ensure that all care needs were accurately documented. Evidence: A statement of purpose and service users guide were in place at the service to outline the type of care and facilities that Lee Road has to offer. The manager was aware that these need to be updated to reflect the change of manager and to be made available in a more accessible format for people using the service. The manager was able to show a version of an accessible service users guide on the computer, which he had prepared at a previous care service he managed, and this had been produced using pictures, colour, and plain text. He envisaged adapting it for Lee Road. The last person to be admitted to the service moved in around November 2007. The service user was met during the course of the inspection and had settled in well and said he liked living at Lee Road. Pre-admission information was looked at in his file. A record of visits to the service had been logged to show that he was given opportunity Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: to see the accommodation, meet staff and people using the service. A pre-formatted assessment form had been used to record his care needs. Significant gaps were noticed throughout and the overall quality of information recorded was poor. For example, there was no information in a section on medication, health care needs and care needs. The pen picture was blank. Under other physical health information the word skin had been handwritten with no explanation. Under diet, the person undertaking the assessment had written not, healthy living, milk with no further explanation. Under alcohol and/or drug abuse was written yes, orange, coke, crisps, one a day with no further explanation, under continence the person had written ?goes himself. The form had not been dated or signed. A requirement is made for thorough assessments to be undertaken of any prospective service users and for these to be undertaken by a person who has suitable experience and skill to do so. A recommendation is made for the statement of purpose and service users guide to be updated and made available in accessible formats to people using the service. Care Homes for Adults (18-65 years) Page 12 of 29 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. There is good regard for the diverse needs of the people living at the service and their requirements related to their disabilities, lifestyle choices and personal preferences are sought, recorded and met by the staff team, respecting their rights, choices and individuality. Evidence: Care plans were in place for each person living at the service. Three files were looked at. Each contained a photograph of the person and a basic information sheet which had space to outline religious and cultural needs and ethnic origin, language spoken, marital status, next of kin and doctor details. Plans to support people with daily living covered day care, medical support, domestic duties, finances, personal care, days out/holidays, family and friends, social and leisure opportunities and diet, there was a daily routine for each day of the week, personal goals and likes and dislikes had been noted. These had been dated and the author noted. Risk assessments were in place to accompany care plans for areas such as personal finances, bathing, supporting in the community, swimming and fire safety. These were dated and signed. Copies of Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: peoples review notes for 2008 were also on their files. People using the service were seen to make decisions about what to have for their lunch, whether to be alone or in company and invited to share in household domestic tasks. Minutes of six house meetings were seen for the past twelve months and these showed that service users are actively consulted about the way the home is run and their ideas sought. Peoples money was being managed safely with individual locked cash tins kept in a secure place and individual transaction records. The tins and records for three people were looked at. Actual balances tallied with recorded balances and records were in good order with receipts in place and signatures to verify expenditure. Another record showed that staff make a daily check of each persons cash tin to check that balances and records are in order. Care Homes for Adults (18-65 years) Page 14 of 29 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. Activities are available to people using the service to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. Food is well prepared and presented attractively to make sure that nutritional needs are met and respecting peoples preferences. Evidence: People using the service have day service places during the week, such as at Thrift Farm and Bierton Hill day service, with at least one day at home. One person was involved with a recycling scheme and another was learning and improving independent living skills through a scheme near Aylesbury town centre. On the morning of the inspection, one person was out at day services, another was in town with staff for a medical appointment and then food shopping for the service, one person was watching television in his room and the rest were enjoying doing some crafts in the dining room with staff. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: People using the service have contact with their family and friends and access the community on a regular basis. One person said he would like to be supported to make use of buses and a member of staff agreed that this could be achieved and would help him, another said they would like to go and see a show and this was responded to positively by staff as well. One person likes Elvis Presley and is supported to go to concerts by impersonators, such as a recent event at the local Civic Centre. People using the service were keen to have holidays again this year; two had travelled to Bulgaria last year and had a successful holiday, another wanted to go to the Caribbean. Two people attend church. An aromatherapist visits once a month. Routines within the service were observed to be flexible to fit in with peoples wishes and preferences. People using the service said they liked the food. At lunchtime they had sandwiches with healthy eating crisps, a drink of their choice and a selection of fruit to follow. Staff made sure that fruit was washed before eaten and had prepared the sandwiches attractively. A menu was displayed on the kitchen notice board and reflected peoples selections for the week. The main meal of the day was to be jacket potatoes with tuna and salad. Shopping for the home had taken place in the morning with a service user assisting the member of staff. Other service users assisted to bring the shopping bags in and unpack. Several service users said they like eating out, either for main meals or enjoying coffee and cake somewhere, and have opportunities to do this. Care Homes for Adults (18-65 years) Page 16 of 29 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 health and personal care needs of people living at the service are well managed overall, promoting health, well-being, taking into account their preferences and religious or cultural requirements and ensuring that they receive medication in a safe and consistent manner. Evidence: Care plans reflected any support that people need with their personal care and appointments with a range of health care professionals such as nurses, doctors, a dietician, audiologist, podiatrist, optician and consultant psychiatrist were noted. In the sample of files that was looked at, there was no record of people attending dental appointments and a recommendation is made for the manager to look into this and arrange appointments if necessary. Records of peoples weight were being recorded. Health action plans were seen to be in place. Where one person needed some help in changing a corn plaster, staff took the person to their room to do this in private. One persons needs had changed due to the onset of dementia. The care plan had been updated to reflect changes and the manager had involved a care manager from the local authority to make sure that the right care is in place. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Medication was being managed using a monitored dose system. Each person had a medication cabinet in their room and a medication pen picture which showed photographs of each type of medicine prescribed for the person, what it is for and side effects. Medication administration records were in good order with initials alongside prescribed dose times. Storage arrangements were satisfactory. A sample of staff training records showed that they had attended training on medication within the last twelve months. Care Homes for Adults (18-65 years) Page 18 of 29 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. Procedures are in place to respond to complaints and safeguarding issues to make sure that people using the service are listened to and protected from risk of harm. Evidence: In information provided by the manager, no complaints or safeguarding issues were recorded. The Commission is not aware of information to the contrary and has not received any complaints or safeguarding alerts directly. Procedures were available in the operations manual to make complaints and a policy was in place for safeguarding vulnerable adults. There was also a policy on managing challenging behaviour. The service had a copy of the local authority inter agency safeguarding procedures in place as well. During a tour of the premises it was noted that each persons room had an accessible version of the complaints procedure displayed for them to refer to. The manager advised that one person has an independent Mencap visitor and that an advocate is involved with everyone. A sample of training records showed that staff had attended training on safeguarding within the past year; the manager had last attended training in 2007 and will need to refresh this. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is homely and clean but needs some attention outside to improve appearance and keep it in a well maintained condition. Evidence: The service is located on the Southcourt residential estate in Aylesbury and is close to a bus service, local shops, the town centre and Stoke Mandeville Hospital. The building was previously two semi-detached properties that have been knocked through to create one dwelling. One bedroom is located on the ground floor and has an ensuite shower and toilet, the remaining bedrooms are upstairs. Each person has a single bedroom, varying in size and outlook. Each bedroom that was seen had been decorated to the persons taste and personalised with their belongings. Bedrooms were close to bathrooms and toilets. Upstairs there is a bathroom and a separate shower room. There is also a bathroom on the ground floor. The lounge and dining room had been decorated and arranged to resemble a large family environment and were comfortable to sit in. The kitchen is a good size with laundry equipment and the boiler down one end. Food was being stored safely with dates of opening written on packages in the fridge. Cupboards were well stocked following a food shop earlier in the day. The service was being kept clean and toilets were stocked with all necessary supplies. There were no unpleasant odours around the Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: building. A window cleaner visited the service during the day as part of a regular arrangement. In the pre-inspection self-assessment, the manager outlined problems the service has encountered with the housing association which is responsible for maintaining the outside of the property and communal areas. Windows and the path by the back door were in need of attention, as was the garden. One requirement and a recommendation are made to improve the environment. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. Evidence: At the time of this visit there was one staff vacancy for a part time, 18.75 hours, vacancy. There were five care staff in the team, two of whom have National Vocational Qualification level 2 or above. The manager and two carers were on duty at the start of the inspection, one of whom was supporting a service user in the community and returned at lunchtime. All staff present during the inspection were observed to be gentle and patient in their interactions with people using the service and engaged with them positively, taking an interest in them. Rotas showed that there are usually two staff on duty during the waking day with one person sleeping in at night. No regular night time personal care needs were evident in care plans or from speaking with the manager. Changes had been made to the rota since the last inspection to make it more flexible and staff reported that this was now working well. Three recruitment files were looked at. All required checks were seen to be in place. One persons file needed to contain a photograph of the member of staff. Training records for a sample of staff were looked at. Overall, staff were up to date with Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: mandatory training with a couple of updates needed, such as one person who last attended food handling training in 2004 and the manager who last attended safeguarding training in 2007. Specialist courses had also been undertaken by some staff, such as control of substances hazardous to health, communication and dementia awareness. Induction records were in place for newer staff, following the Learning Disability Award Framework. In the pre-inspection self-assessment, the manager said that staff supervision had fallen by the wayside during the period in between permanent management of the service. This was an area of practice he was aiming to improve over the coming year. Care Homes for Adults (18-65 years) Page 23 of 29 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. There is now permanent management at the service to promote continuity for people using the service. Health and safety is overall well managed but needs some attention to ensure gas and electrical safety are satisfactory. Evidence: The manager joined the team as a permanent member of staff at the beginning of January, prior to that he had been providing management support since the summer. No notification had been made at the time of his appointment although this has been rectified since the inspection. The manager is experienced in working with people with learning disabilities and has been a registered manager before. He holds a foundation degree in care management and has achieved National Vocational Qualification level 4. He will be applying to become registered for Lee Road. Regular monitoring of the service had been taking place with reports available of the findings. Various health and safety checks were in place to reduce likelihood of accidental injury Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: at the service. The most recent visit from the fire officer took place in 2006 when a satisfactory outcome was noted. There was a fire procedure in place, the means of escape was being checked daily, weekly fire alarm testing was taking place and was up to date and fire extinguishers were being checked regularly. Emergency lighting was being checked every three months and fire practice evacuations were recorded for December 2008 and January 2009. The fire alarm had been serviced in February this year. Fridge and freezer temperatures were being checked each day, cold water was being checked each month and hot water temperatures were being monitored. Shower heads were being cleaned and descaled monthly. The most recent gas safety certificate was dated January 2008. The manager had not been given a date for a contractor to visit to re-check appliances. A requirement is made to address this. In the pre-inspection self-assessment the manager said the most recent check of the electrical hard wiring took place in December 2003; a new check is needed every five years and a requirement is made to make sure that this is done. Portable electrical appliances had been checked in April 2008. The most recent visit from an environmental health officer took place in April 2008 when the officer reported during my visit I was pleased to find the premises clean and tidy. Some minor advice was given at the time. Accidents and incidents were being recorded by staff and countersigned by management. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 2 14 Assessment of prospective 06/04/2009 users is to be undertaken by a person with suitable experience and skill to do so and must provide a detailed and accurate account of peoples care needs in order that an informed decision can be made on the persons suitability to live at the service. A certificate of satisfactory electrical hard wiring is needed to make sure that the premises are safe. 30/04/2009 2 42 13 3 42 13 An up to date gas safety 30/04/2009 certificate is to be obtained to ensure gas appliances are in satisfactory working order. Care Homes for Adults (18-65 years) Page 27 of 29 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 1 The service users guide and statement of purpose are to be updated and produced in formats accessible to people using the service. Dental appointments are to be made for people using the service where they have not received recent check ups. 2 19 Care Homes for Adults (18-65 years) Page 28 of 29 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 © (2009) Commission for Social Care Inspection (CSCI). 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