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Inspection on 05/03/09 for Paks Trust 66 Oaston Road

Also see our care home review for Paks Trust 66 Oaston Road for more information

This inspection was carried out on 5th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Prior to people coming to live at Oaston Road they have access to information to help them make informed decisions about moving home. Information is shared between the person moving and the staff team so that everyone is clear and in agreement about whether or not the home can meet the person`s needs. People living at Oaston Road have a care plan that reflects their key needs and shows their opinions and choices. Staff are strongly committed to continuing improvement to care planning so that people`s aspirations and goals are included. Staff have worked with people living at Oaston Road to identify how they might achieve their goals. People living at the home could access health care services when they needed to and they received their prescribed medication safely. People living at the home had assistance to make choices about living healthily and some people had made lifestyle choices to achieve healthy living goals. People living at Oaston Road enjoyed a comfortable and homely environment. People enjoyed a clean and tidy home which was well maintained.

What has improved since the last inspection?

People considering moving to Oaston Road can now access a range of information which has been made available in picture imagery. People who already live at the home now have a copy of the Service Users` Guide and complaint procedure in their rooms with picture imagery to make it easier to follow. People living at Oaston Road have talked to staff about their lifestyle choices and their care plans. This has resulted in working together and completing risk assessments for every day living for example using a kettle and sharp knives. People have been able to say what they feel they are independently able to do and what they feel they need some support to do. Since the last inspection the home has been redecorated in parts as part of an ongoing renewal and maintenance programme.

What the care home could do better:

The home could improve the outcomes for people living at Oaston Road by making a few changes. The home has considered the safety of people at the home if they were in the house alone but they should consider how being home alone would affect people differently. They should complete individual risk assessments to show this issue has been thoroughly addressed. The home has a comfortable environment to offer people but a review of the premises and consultation with a health professional for people with physical needs should be completed. Information about the home should show any limitations for people with physical needs. Reasonable adjustments should be made to accommodate the choices of people currently living at the home so that all of the facitlities are accessible.The home has responsible staff who have a clear understanding about preventing abuse of Vulnerable Adults but the home should gain training for all staff in Protection Of Vulnerable Adults and Safeguarding. The home does have thorough recruitment processes so that potential staff are established as suitable to work with vulnerable adults but the home could make closer examination of the information they receive and follow up any queries.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Paks Trust 66 Oaston Road 66 Oaston Road Nuneaton Warwickshire CV11 6JZ     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: Paula Dutton     Date: 0 5 0 3 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 28 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Paks Trust 66 Oaston Road 66 Oaston Road Nuneaton Warwickshire CV11 6JZ 02476742201 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: PAKS Trust care home 5 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: 5 The registered person may provide the following category of service only: Care Home Only (Code 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) 5 Date of last inspection Brief description of the care home The home is a 5 bedroomed narrow, long and tall Victorian end of terrace house in Nuneaton. The accommodation comprises of a lounge, kitchen diner, lean to/conservatory room, one bedroom, shower room and separate toilet on the ground floor. On the first floor there are two residents? bedrooms and a bathroom. The other two bedrooms and a separate toilet are on the top floor. The staircase in the house is narrow and steep, with very little natural light. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 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 Star. This means the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focusses on aspects of the services provision that needs further development. The visit to the home was undertaken by one inspector over a period of four hours and the registered manager was present during the inspection to assist in the process. The home did not know that we were visiting on that day. There were four people living at the home on that day and three of these people took part in the inspection. Care Homes for Adults (18-65 years) Page 6 of 28 Information was gathered from speaking to and observing people who lived at the home. Two people were case tracked which involved looking at their experiences of living at the home by meeting or observing them, looking at medication, reviewing personal care files and areas of the home used by those people so that we can focus on outcomes. Case tracking helps us to understand the experiences of people using the service. In addition a range of documentation was viewed including staff files, training records, rota records, personal care plans and daily notes, discussion with staff and the manager. Prior to the inspection the registered manager had completed and returned an Annual Quality Assurance Assessment (AQAA). This tells us how wekk the home thinks it is performing and gives information about their achievements through improvement and their plans for further development. Surveys were sent to people living at the home and to staff working at the home so we could consult those directly affected by the performance of the service. There were two requirements made and four recommendations made. What the care home does well: What has improved since the last inspection? What they could do better: The home could improve the outcomes for people living at Oaston Road by making a few changes. The home has considered the safety of people at the home if they were in the house alone but they should consider how being home alone would affect people differently. They should complete individual risk assessments to show this issue has been thoroughly addressed. The home has a comfortable environment to offer people but a review of the premises and consultation with a health professional for people with physical needs should be completed. Information about the home should show any limitations for people with physical needs. Reasonable adjustments should be made to accommodate the choices of people currently living at the home so that all of the facitlities are accessible. Care Homes for Adults (18-65 years) Page 8 of 28 The home has responsible staff who have a clear understanding about preventing abuse of Vulnerable Adults but the home should gain training for all staff in Protection Of Vulnerable Adults and Safeguarding. The home does have thorough recruitment processes so that potential staff are established as suitable to work with vulnerable adults but the home could make closer examination of the information they receive and follow up any queries. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 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 28 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 considering moving to the home have an assessment and sufficient information so that they know the home can meet their needs and they can make an informed decision about moving in. Quality in this outcome area is good. Evidence: The homes AQAA said they provide information to people who are thinking about moving to the home. A person living at the home said he had got copies of the information in his bedroom. On entering his bedroom there were documents displayed behind the door containing information illustrated through pictures. This showed the range of the services and what someone should expect if they lived at the home. Evidence viewed in two files belonging to people already living at the home showed the home had gained assessments completed by outside professionals including social workers. Care Homes for Adults (18-65 years) Page 11 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Oaston Road have a care plan showing their needs and how staff are expected to assist them. They can be independent and lead fulfilling lives within a reasonable level of risk taking. Quality in this outcome area is good. Evidence: The AQAA said the home developed care plans and risk assessment so that people living at the home could acheive their goals and fulfil their lifestyle aspirations. People living at the home are encouraged to take responsible risks so that they could maintain their independence. People living at the home said they could take part of lots of activities and they said they enjoyed going on outings. They said they really enjoyed getting ready for short breaks and holidays. People living at the home said they went out frequently to take part in community activities such as going to the gym or attending work placements. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: One person sat talking with the inspector and a member of staff about their care plan. The person discussed how accurate their care plan was and how it was important to take part in making a care plan. They had clear views about how he wanted to live his daily life and listed his goals and aspirations. A discussion took place about being home alone during the day time. Some people living at the home sometimes return home when staff are not there. The manager had explained this has been the case for many years for some people. The inspector asked the person living at the home about security in the house when there were no staff around. They told us that they liked coming home when he needed to come home and did not want staff objecting to him making this choice. A staff member was responsible for writing risk assessments for most activities in the home and risk assessments relating to each person living at the home with the managers guidance. Evidence in individual risk assessments and general risk assessments showed careful consideration had been given to most activities of daily living including daily tasks involving sharp knives and using the kettle. This member of staff said whilst there was a general risk assessment for everyone being in the home alone they will be working on individual risk assessments. It was discussed how different people can be and how the risk assessment process and records will show staff and people living at the home have thought about these issues thoroughly. Care Homes for Adults (18-65 years) Page 13 of 28 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 living at Oaston Road can make choices about how they live and are assisted in accessing community living. People can enjoy a varied and nutritionally balanced diet. Evidence: The AQAA said people living at Oaston Road can be assisted to make choices and decisions about their lifestyle and daily living. There were three people iving at Oaston Road who expressed their opinions about how they spend their time. A person told the inspector how pleased they were to have achieved their healthy living goal by going to the local gym. They told us that another person at the home came too and they both enjoyed this. Another person told us about their relationships with other people, and that they were able to visit their family every weekend and speak to them on thephone. During our Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: vist this person had a call from the family. The staff explained how people living at the home are assisted to find work placements. A person who lives at the home confirmed attendance to a work placement and siad they enjoyed this. They also told us they had been assisted by staff to join a work place agency that offered support to find employment placements. All of the people living at the home can choose to eat a varied and nutritionally balanced diet. An interview with a member of staff established the home shops frequently at a supermarket and people living at the home take part in the shopping decisions. A staff member said the freezer is always full and people can always ask for choices in foods. This member of staff had completed training in Food Hygiene. An audit of the personal finances found that people living at the home are assisted to purchase goods of their own choice when shopping. There were receipts of purchases made by individuals. Care Homes for Adults (18-65 years) Page 15 of 28 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. People living at Oaston Road have their health care needs met and receive their prescribed medication accurately. Quality in this outcome area was good. Evidence: The AQAA told us that the home assist people living at the home to access the health services they need. It said there are regular health reviews and medication reviews with doctors. The inspection found that care plans and daily notes confirmed that people did have access to their doctor or other health professional when they needed. Care plans showed people had said what they would like to achieve in living a healthy lifestyle. Some people had set themselves goals in weight management and said they had achieved their goals. An audit of the medication found the home had a robust and safe system for management and administration of peoples medications. A member of staff showed Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: the inspector where and how medication was managed. The medication was stored in a lockable cupboard and contained further metal lockable boxes. Most medication was stored in blister packs part of the monitored dosage system. The Medication Administration Records (MAR) showed all medication was booked into the building and all had been signed for as given. A spot check of the remaining stock of medication found the records to be accurate. The member of staff explained very little medication is not taken but they do have a system of correct disposal of medication that has been discarded using small individual plastic bags. Medication is reordered over the telephone to the chemist so the home had not gained copies of the original prescriptions. The manager said the home would review this arangement with the chemist. The manager had introduced a written record to track the ordering of medication. Some medication was as required or PRN medication. The member of staff explained the medication was only administered in specific circumstances. Medication was only administered in this way once a call had been placed to the on call manager. A record was kept showing the details of the dose of medication. The manager said the home would produce a risk assessment or protocol showing the range and limitations of this type of administration of medication. Care Homes for Adults (18-65 years) Page 17 of 28 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. People living at the home are listened to and actions are taken to address any conerns or comments made. People have their rights and welfare promoted and protected. Quality in this outcome area is good. Evidence: The AQAA said the complaints procedure was readily available. On touring the home the complaints procedure was displayed clearly in the kitchen. A person living at the home said if he had a complaint he would speak to Alan the manager. The AQAA said the staff are made aware of policies and procedures for preventing abuse of vulnerable adults and the whistleblowing policy. Policies and procesures and a copy of inspection reports were readily avilable in the kitchen. The manager said each new member of staff has an induction including prevention of abuse awareness training. An interview with the manager estblished that most training had taken place within the last twelve months including prevention of cross infection and food hygiene. This knowledge protects vulnerable people from illness. Staff had not received up to date Protection of Vulnerable Adults and Safeguarding training. Evidence in a staff file suggested some staff have not had training in this for Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: more than eighteen months. The manager said this training will be arranged for as soon as possible. An interview with a member of staff estblished the home does inform staff about types of abuse and what to do in the event of having any concerns. The staff member had a very good knowledge of the types of abuse and knew which agencies to go to with information outside the company. Discussion with the manager about a complaint investigation established the company does act responsibly in addressing performance issues from staff. The manager said he will send documents relating to an investigation to us for our records. The AQAA said there are accurate records kept in the home of personal finances. During the inspection there was an audit of two peoples personal finances. Each person had very thorough records kept individually of all money spent and receipts matched money spent. Each person had a small balance kept in a tin and a smaller amount was available in a small container. All money was stored securely and the manager had full control of the keys. Care Homes for Adults (18-65 years) Page 19 of 28 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 living at Oaston Road benefit from a comfortable and homely environment however people with physical needs cannot access to the whole home and therefore not access all of the services. Quality in this outcome area was adequate. Evidence: The AQAA told us the home is suitable and safe for use by everyone living at the home. A tour of the building found all areas were clean and tidy. Two people who live at the home talked to the inspector about their bedrooms. They said they were happy with their bedrooms and had their personal possessions and property in their rooms including clothes, ornaments and photos. One person said thee wanted to use the upstairs bathroom sometimes to take a bath but was restricted to the downstairs shower room only due to his mobility needs. He told a member of staff that they thought they could walk up the stairs if there were bannisters on both sides of the stair case. The person on duty said they would find out about getting this changed. Care Homes for Adults (18-65 years) Page 20 of 28 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. People living at the home receive assistance from sufficient staff who are professionally competent. Quality in this outcome area is good. Evidence: The AQAA said the staff are recruited, trained and supervised responsibly. The manager explained the process of interview and appointment included suitable checks. A staff file was viewed and this confirmed checks had been completed by gaining two written references and a Criminal Records Bureau check. Disussion took place with the manager about following up any references or Criminal Record Bureau checks that may require more explanation. The manager said the protection of people living at the home was a priority and recruitment would be thorough. The AQAA said staff are supported and supervised in their roles. The manager told us that supervision is planned throughout the year but not always delivered due to leave and sickness. A member of staff said he did have supervision and his file showed he had received supervision. Staff said that the manager is very approachable and is Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: available in the building frequently for advice and support. The AQAA told us there is always sufficient staff on duty to meet peoples needs. A rota showed staff were on duty when people were expected to be in the home. An interview with a member of staff established that the rota is always planned ahead and if there is sick cover needed someone on the team will do it or the manager comes in. Care Homes for Adults (18-65 years) Page 22 of 28 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. People living at the home benefit from a well organised and efficiently run service. Quality in this outcome area is good. Evidence: The AQAA told us the manager is competent and qualified to run the home. Two members of staff said the manager was often available and was very supportive. Staff said they felt that the management were approachable and open in the way they operated the home. Observation found the people who live at the home were confident in talking to both manager and the director. The AQAA told us there are policies and procedures available for staff to read. Observation found the policies and procedures were displayed for staff to access easily. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: The manager had worked with one member of staff in his professional development in the area of risk assessment. The member of staff told us he had guidance from the manager on the main features of a risk assessment. A general risk assessment had been completed for people being in the house alone. On arriving at the home we found a person alone in the property who answered the door, giving his name and saying there was no one else home. He told us that he did not know who to ring and did not have any phone numbers. The manager said he would look at producing a specific risk assessment for safety in the home for individuals including security, fire or emergency. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 9 13 Risk assessments and plans of care are needed for the risk of being at home alone. This is to ensure that all areas of risk are recognised and actions put into place to minimise these. 31/05/2009 2 23 13 Up to date training in safeguarding and the management of alleged or suspected abuse must be made available for all staff. This will ensure that all staff have sufficient knowledge to safeguard those they care for. 31/05/2009 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 1 20 The home should produce a risk assessment or protocol for the range and limitations to PRN medication and reflect this Care Homes for Adults (18-65 years) Page 26 of 28 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 in the care plans. 2 20 The home should gain copies of prescriptions for medication and prescription details for ordering should not occur over the telephone except in an emergency. Should the prescription be discussed over the phone for ordering purposes the home should agree a protocol of communication with the chemist to ensure the risk of error is minimal. The home should ensure people living at the home are assessed for level of vulnerablility and staff should be made aware of each individuals risk and the measures to be taken to protect them. All people in the home should have an occupational health risk assessment to assess what they are capable of and adjustments made to the environment where required to ensure independance for each person. The home should follow up references or criminal record brueau checks that need further explanation. 3 23 4 29 5 34 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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). 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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