Inspection on 28/10/08 for Leonora Street

This inspection was carried out on 28th October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Leonora Street 20 Leonora Street Burslem Stoke-on-Trent Staffordshire ST6 3BS     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: Rachel Davis     Date: 2 8 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 29 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 29 Information about the care home Name of care home: Address: Leonora Street 20 Leonora Street Burslem Stoke-on-Trent Staffordshire ST6 3BS 01782817655 01782815294 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Carol Padley Type of registration: Number of places registered: Creative Support Ltd care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 16. The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 16 Mental Disorder (MD) 16 Date of last inspection Brief description of the care home Leonora Street is a registered home for younger and older adults who have mental and physical health related conditions. All the people living at Leonora Street presently require differing degrees of nursing input. Leonora Street has recently been purchased by Creative Support , it was previously part of the Richmond Homes Fellowship. Apart from the change of ownership all other aspects remain. The registered manager is Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 16 0 0 16 Brief description of the care home Carol Padley who has been in post for a number of years. The staff team remains stable and there have not been any new admissions for the past two years. The costs for this service are not included within the service user guide and therefore direct contact will need to be made to ascertain this information. Leonora Street is well situated and enables people who live there to enjoy the local community. Staff tell us Creative Support Ltd have introduced positive changes for the people living here. 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 inspection took place over 1 day and was unannounced, this means the people who use the service or the staff did not know we were coming. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who live in the home and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, national minimum standards of practice and focuses on aspects of service provision that may need further development. A quality rating is provided throughout the report based on each outcome area for the Care Homes for Adults (18-65 years) Page 6 of 29 people who use the service. These ratings are described as excellent, good, adequate or poor based on findings of the inspection. Before visiting the home on this inspection, survey information was completed and returned to us by people who use the service and the staff. The service also has to complete an annual quality assurance assessment to tell us how they meet the needs of the people who use, or may use the service. This focuses on what they do well, how they evidence this and any areas in need of improvement. When we are there we focus on a small number of people who use the service which involves discovering individual experiences of living at the home by meeting them, discussing their care with staff, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. This helps us to understand the experiences of people who use the service. We looked around the home to make sure that it was warm, clean and comfortable. We looked to see whether people who use the service are being protected and the arrangements the service has for listening to what people think about Leonora Street. There were no immediate requirements made after this visit. This means there was nothing of significant importance that needed to be done to make sure people stayed safe and well. 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 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are appropriately assessed prior to admission. The service user guide should offer more information to further support people in making an informed choice. Evidence: A copy of the homes statement of purpose and service users guide are available at the home and describe the scope of the service and its philosophy of care. A pictorial version of the guide is being produced to explain the service in a format that is more accessible to people using the service. Information on local advocacy services has been included. The service needs to be more explicit with their guide and include information about the fees, this should also offer people advise on what they will receive for their money eg, are excursions, a holiday, or activity budgets included within the fee. This means people will be clear of what to expect and enable individuals to make informed choices. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: No new admissions have taken place since Leonora Street became part of the Creative Support Group in June this year. The manager of the service tells us assessments are undertaken before any decision is made and we were able to evidence this in peoples files , these are called plans of care. We saw that written information from the social worker and other significant people is kept in the care planning file and used to support formulating and writing the care plan. A risk assessment has been developed which is completed by social workers as part of the assessment process before people move to the service. This shows that the service is careful to confirm they can meet the needs of people using the service. Care Homes for Adults (18-65 years) Page 11 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 using the service. Information could be expanded upon to fully support people in living their lives in the way they so choose. Evidence: Care plans are in place for each person living at the service and these follow a corporate format. Essential information such as religion, ethnic origin, next of kin and doctor details are recorded. We felt there was a lack of information about people’s preferred daily routine, activities, likes and dislikes. We discussed this with the manager during the inspection who agreed with this. She said they were still changing over documentation from the last owner, Richmond Fellowship to the new owner Creative Support. The manager was able to show us Wellness Recovery Action Plans paperwork (WRAP) which she is currently being trained to complete. These plans are focused on Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: individual, person centred care, and enable people who use the service to contribute to their plans in a meaningful and positive way. When these are completed plans of care will be very focused, explicit and person centred. The Annual Quality Assurance Assessment also tells us that Leonora Street involves people who use the service in the development of their support plans and risk assessments. Plans of care provide evidence to show information required with regard to the Mental Capacity Act 2005 have commenced. Decision record sheets are in place and people are assessed by the General Practitioner when they lack capacity. There is also a checklist and a decision record in place. Assessments confirm advocates are involved and Independent Mental Capacity Act ( IMCA) advocates have also been included where necessary. People were seen to make decisions in the home, such as what they wanted for breakfast and where they sat and from discussions they said they made decisions about what to do in their spare time. House meetings between people who use the service and staff take place at the home fortnightly to discuss any issues. People living at the service required assistance with managing their money. People were making use of ordinary high street banks/building societies and withdraw money on a regular basis for purchases. Each person had a wallet kept in the office for safe keeping. Records were being maintained of expenditure, with receipts kept to verify spending. Money was kept secure but a check of one wallet showed that actual balances did not quite tally with recorded ones. The manager said she will talk with staff to ensure they record accurately. Staff were seen using preferred communication methods when engaging with people who use the service. All documents are up-to-date to reflect current care needs (except where more detail is required as mentioned earlier) and have been signed by staff and the person using the service. Risk assessments are in place to accompany care plans and have also been signed and kept up-to-date. The home is supporting people to take acceptable risks, such as going out independently and being involved in relationships. Care Homes for Adults (18-65 years) Page 13 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. People using the service are involved in a range of activities to provide them with stimulation and contact with family, friends and the local and wider community. Varied meals are prepared to make sure that nutritional needs are met whilst respecting people’s preferences and medical requirements. Evidence: We looked at the plans of care for two people using the service, we also talked to staff about how they support people using the service. These show there are opportunities to maintain and develop social skills and take part in age appropriate activities, for example going to local support groups, cookery, gardening, places of interest, art classes and regular outings. People who use the service said they enjoyed living at Leonora Street, one person said Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: I love it another said Its good here, I like it. People are involved in the local community through activities such visiting the cafes, clubs, pubs, shopping and going out for walks. Staff tell us there is now more time for activities, there is a separate budget for this, flexi shifts are available, and the planning of activities are quite often spontaneous. People are supported to go out in small groups or on a one to one rather than in large groups. On the day we visited 5 people were off to Blackpool to see the illuminations in the homes people carrier, another small group of people were going later in the week. The Assurance Quality Assurance Assessment ( AQAA) tells us that People who use the service are part of the community and local activities. People were receiving varied meals and had chosen to plan their menus on a weekly basis and discuss this regularly at the residents meeting. A number of people prepared meals with support or independently and this seemed to work well. A range of foods were available in stock to facilitate choices. There was a good selection and ample quantity of fresh fruit was in the dining room and people were free to help themselves. Healthy options were available at the service, such as low fat spreads, these options were clearly displayed on the menu board sited by the kitchen door. Care Homes for Adults (18-65 years) Page 15 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 home are well met. Medication records need some attention to make sure that safe practice is always followed Evidence: Surveys sent in on behalf of people using the service tell us that Leonora Street always meets peoples needs and always or usually gives support in the way that has been agreed. Comments include, I like making my own decisions and I enjoy living here they treat me well. People living at the home are making use of community health care facilities, such as doctors, dentists, opticians and the consultant psychiatrist in learning disabilities. Routine health checks are being undertaken regularly and preventative measures such as breast screening are taking place where people wanted this. Medication is being managed using a monitored dose system whereby the pharmacist pre-packs tablets into blister packs. The medication cabinet is secure and kept locked Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: when not in use. A medication fridge is in place and the temperature is maintained. We recommend the service purchases a maximum and minimum digital thermometer if insulin or eye drops require storage, this will ensure they are stored within an appropriate temperature range. There is a medication policy in place to provide guidance to staff. We have asked the home to offer better information about people who self medicate. Presently it is not always clear , for example, one persons medication administration records reads requires supervision however, they do fully self medicate. We have asked for records to offer information on how to manage individual situations, for example, as and when required medication. This should evidence the person is aware of the medication and how, when and why they would ask for it, or administer it, and if they have the capacity. We checked the controlled drugs register and this tallied with the medication presently in stock. The service has not mentioned anything about medication or the management of such within their Annual Quality Assurance Assessment ( AQAA), we feel this needs to be included to help support and evidence that the service manages this area appropriately. Care Homes for Adults (18-65 years) Page 17 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. People can be sure their complaints are listened to and taken seriously. Evidence: The service had a complaints policy and whistle blowing procedure in place. In the Annual Quality Assurance Assessment ( AQAA) the manager said there had not been any complaints since their registration with the commission and the complaints log verified this. No complaints have been made direct to the commission in this time. People using the service and their families have been given a copy of the complaints procedure and a pictorial version is also available. We noted the complaints procedure does not offer people a timescale , this needs to be reflected so people know when their complaint or concern will be responded to. The service also has a letter box where anybody can raise a complaint or issue anonymously. Staff said in surveys that they were aware of what to do in the event of anyone raising concerns about care practice. There are safeguarding and whistle blowing procedures in place. Training records reflect that the staff have received safeguarding training. On talking with staff and Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: analysing questionnaire responses we can confirm the staff team are aware of these issues and how to deal with them. We have asked the manager to obtain a copy of the Safeguarding of Adult policy, this will ensure the staff team follow any updated procedures correctly. No incidents or allegations of abuse were noted on the Annual Quality Assurance assessment ( AQAA) and the commission has not been made aware of any from other sources. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, secure and homely environment. The home makes sure they have the right specialist equipment to encourage and promote peoples independence. Evidence: Leonora Street is a two storey property that is in a satisfactory state of repair. The home has a refurbishment plan and people who use the service are actively involved in how areas of the home are utilised and managed. People confirmed they have involvement with choice and, liked living here. One area that has been refurbished is now used as a private dining area where people can cook and eat with friends and family without having to involve the main kitchen. People come and go as they please, a number of people have a key to the front door and to their own rooms. It was pleasing to note the art work in the home had been completed by the people living there, there was a selection of collages and pictured displayed throughout. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The laundry is in good order with products locked away safely. Standards of cleanliness were good with kitchen, bathroom and laundry areas kept clean and the staff team showing good regard for infection control. We have asked the manager to ensure they have adequate information with regard to smoking areas and any decisions made, this should be clearly reflected within the homes statement of purpose and service user guide. 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. Staff are suitably recruited to make sure people who use the service are protected but the staff files must be kept on site. Staff are trained to meet peoples needs though some updates are required. Evidence: We tried to look at two staff files but they were not available on site. When discussing this with the manager we found a number of files were being signed off at HQ. We telephoned HQ and spoke to them about this. The service understands that staff files must be at Leonora Street and have recruited somebody to specifically clear this backlog. We asked for proof that people had suitable criminal record disclosures in place and asked for these to be faxed to Leonora Street. This was done and we can confirm the recruitment of staff is safe and protects the people using the service. This includes two written references, criminal records bureau checks, application forms that cover gaps in employment history and the required identification certificates, health declaration. We reminded the manager that photographs of staff are required on files also. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Male staff are recruited to the home, which promotes equality and choice. During the time we spent at Leonora Street we spoke to a number of staff and observed them supporting people. We found there were positive and engaging interactions between those people living at Leonora Street and the staff members. Staff reported, we have more time to spend with residents we work well as a team we have better staff levels now we have an activity budget which we didnt have before. All staff receive relevant training that is focussed on delivering improved outcomes for the people who use the service. We found the staff require training in moving and handling as this is now out of date. The manager was aware of this and understands it must be looked at as a matter of priority. Staff report they are supported to meet the individual needs of people who use the service. To further this, the home offers staff training in equality and diversity and the Mental Capacity Act 2005. We checked to see if staff were being appropriately supervised and supported , records and discussions with staff confirmed this to be so. 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. People using the service get the right support because the manager runs it well, with an open approach that makes people feel valued and respected. Evidence: Communication between staff, people who use the service and outside professionals works well. Records such as daily diaries, key worker and resident meetings are all up to date and in good order, which shows that the well being of people using the service is being monitored and improvements are being made as needed. Staff feel supported by the manager and said they felt listened to. One questionnaire revealed, I feel the staff have time to spend with the client group and the home responds well to the needs of the service users. The annual quality assurance assessment has to be completed by every service before their inspection. The annual quality assurance assessment, AQAA , is not as Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: informative as it could be and it should give us more information about the service and offer strong evidence to support the claims made within it. The annual quality assurance assessment does tell us that the home supports people in looking at their personal notes and encourages them to become involved with risk assessments and support planning but it does not tell us how they do this. The service has recently been registered with us and as yet has not had an opportunity to complete a quality assurance questionnaire but the manager told us it has been recognised within the company business plan. This shows that the service understands the importance of monitoring the quality of its work. Although people using the service can not always respond to our questionnaires the staff have filled out these questionnaires based on what they know of the person and their current state of well being with the individual . One returned questionnaire said, X did not like being swapped from one ward to another so was pleased to move to Leonora Street. Another said, Y knows if they have any problems to speak to the person in charge. The service also carries out internal unannounced monitoring visits , these are known as Regulation 26 visits, and are another way the service can monitor how the home may be able to improve. 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 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 People who use, or may use the service, should be offered more explicit information on what services are provided, this means people can make more informed choices. The service user guide needs to contain information with regard to the costs for living at Leonora Street. Information within the plans of care should offer more information on peoples personal preferences. This means staff have all the information necessary to fully support people in living their lives in the way they so choose. The medication administration records for the people who use the service should be more explicit and confirm fully how medication is managed. This ensures all parties know what is expected. A record of the maximum and minimum temperature of medication stored in the fridge should be recorded. This will ensure medications are always stored within the correct temperature range. The home should ensure their complaints procedure has an identified timescale so people can be assured of when they will receive a response. The manager should ensure a copy of the safeguarding of adults is available to support staff in decision making and Page 27 of 29 2 3 1 6 4 20 5 20 6 22 7 23 Care Homes for Adults (18-65 years) following any updated procedures. 8 9 34 35 Under regulation staff files need to be on site, this is so current information is readily available. Moving and handling training requires updating, this is to ensure staff are suitably informed on how to move and handle people safely. 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!