Inspection on 12/02/09 for Patricia House

This inspection was carried out on 12th 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

Patricia House 24/01/08

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

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Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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: Patricia House 266 Warwick Road Accocks Green Olton Solihull B92 7AE     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: Martin Brown     Date: 1 2 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 30 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 30 Information about the care home Name of care home: Address: Patricia House 266 Warwick Road Accocks Green Olton Solihull B92 7AE 01216811448 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : middleway@btinternet.com Middleway Care Ltd care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 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 - Code LD (maximum number of places 5). Date of last inspection Brief description of the care home Patricia House is a large detached property located in the Solihull area of Birmingham. It is set well back from a busy main road and to the frontage has dedicated off road parking. The home is close to the shopping centre at Acocks Green, which has numerous shops, public houses and other local amenities. The town centres of Solihull and Birmingham can be accessed by public transport. The gardens are situated to the rear of the property. There is ramp access leading to the front door and into the rear garden. The Home was initially registered in September 2007 to provide care for five adults with a range of learning disabilities. Resident accommodation is on the first and ground floor. Staff offices, sleep-in and shower facilities are on the second floor. The Home does not have a shaft lift or stair Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home lift. All residents accommodated on the first floor are fully mobile. There are five single bedrooms all with shower or wet room en-suite. The Home has a communal bathroom on the first floor for residents who prefer to bath but this is only accessible to those without restricted mobility. Residents bedrooms are all decorated individually and reflect residents differing tastes and personality. Residents can bring some of their own furniture if they wish. There are toilets located on the ground and first floors. There is a pleasant open plan lounge and dining area leading to a raised decked patio overlooking the rear garden. A statement of purpose and service user guide are available to inform residents of what they can expect at the home. Fees are currently £1,275 per person per week. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report has been made using information that has been accumulated by the Commission for Social Care Inspection. The inspection visit was unannounced, so the home did not know we were coming, and took place on 12th February, 2009, between 11am and 5.30pm. All service users were seen over the course of the inspection, as were staff on both the morning and afternoon shifts, and the operations manager. A tour of the premises was made, relevant documentation was looked at, and observations of the interactions between residents, staff and their environment were made. Policies and procedures, and care records were examined, and two service users were case tracked, that is, their experience of the service provided by the home was looked at in detail. Specific elements of other service users care were also looked at in Care Homes for Adults (18-65 years) Page 6 of 30 detail. The Annual Quality Assurance Assessment, containing information about the service, completed by the service, and returned before the inspection, also informed the inspection. Two people living at the home were able to offer views on the service. Relatives of the other two people living at the home were contacted after the inspection, for their views on the service. Staff, management and residents were welcoming and helpful throughout. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Adults (18-65 years) Page 8 of 30 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Anyone considering moving to Patricia House benefits from an introductory process conducted at their pace, through which all concerned are able to be confident that the service can reasonably meet their particular needs and wishes. Evidence: The home currently has one vacancy. A potential person to fill that vacancy has been identified. The manager explained the introductory process for that person, involving an initial assessment, introductory and family visits, a follow-up assessment, with planned longer visits and longer stays, all at a pace the person themselves is comfortable with. One person currently at Patricia House described their own admission to the home. This followed the process above. Statements of purpose and service user guides were seen. These were also available in easy read format, with symbols, and, for a person with visual impairment, a recorded version was available. The manager agreed that using photographs would help make the guides more personalised, informative, and user-friendly, but was also clear that Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: the most relevant way to gain information about the service was to visit it and meet staff and other people living there. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from staff who have a good knowledge of their needs. Support needs are guided by and reflected in regularly reviewed care plans. Residents are supported to make choices, and risks are generally well managed, enabling residents to become more independent, in a safe and supported manner. Evidence: Each person living at the home has a care plan, which includes a Health Action Plan. A sample of two care plans were looked at. These contained assessments of individual needs, regular reviews and updates, daily schedules, guidelines and risk assessments. Much of the details are contained within individual Care and Support Plans, which were comprehensive in respect of individual need and the support required. It was clear from discussion with staff that they were familiar with needs and preferences as detailed in care plans. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: There was evidence of involvement of residents and/or their representatives in individual care plans. In one instance, it was not clear whether statements about care need were from the home or another source. Daily activity schedules were in place for all those living in the home. These helped give a firm structure to each individual day, and were seen as positive by staff and by residents who were spoken to about them. The schedules did not have a date when they were done. Staff agreed that all stand alone elements of care plans should be clearly authored and dated. The manager agreed, in discussion, that residents may benefit from the addition of concise care plans or communication guides that presented, with the aid of photographs, their needs and wishes in a simplified, user friendly format. Residents, depending on their needs, are supported to make decisions. These may range from where to go out, in one instance, to what to eat, in another. Residents decision making is guided, though not forced, by staff, in some instances where people are being encouraged to be more independent. Again, this may vary from people being encouraged to prepare their own meals, with support as needed, to people being encouraged to stand or use cutlery themselves. Risks are inherent in supporting people to be more independent. Where there are particular risks in individual daily lives, or where there are freedoms which may be curtailed because of particular risks, these are generally well documented. One major exception to this was where a person has bed rails. These had always been in place since this person had moved to the home. Although the need for bed rails were noted, their use had never been reviewed, and the risk involved in their use was not clearly assessed. When this was pointed out, the manager was prompt in actioning this, and was able to confirm details of the district nurse the following day in an assessment of them, as part of a move to also get a new bed for this person with new bed rails suitable for that bed, as assessed by the district nurse. This was later confirmed by the relatives of that person. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are helped to participate in fulfilling activities that they enjoy, and are supported to keep contact with people who are important to them. Daily routines and the ethos of the home encourage personal independence, individual choice and freedom for those living in the home. Evidence: The people living at the home all have a variety of activities, in and out the home. Two people can communicate their needs and wishes well, and it was clear they readily take part in a wide variety of activities. Two residents require a lot more support, and are more reliant on individual staff attention and support. Staff engaged with all residents in a positive way, and gave additional stimulation and support where needed. It was evident that people were supported in gaining additional skills, increasing their living and independent skills, whether this be in cooking, or eating at Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: the table. Everyone has activities outside the home, at various colleges, social events in the evenings, which involves everyone being out somewhere on most days. Three people had been out to different activities on the day of the inspection, and the fourth person would normally have been out, but was quite happy to be in and talk to the inspector. Relatives spoken with enthused about the variety of activities available, including college and a farm, and swimming. One person, on returning from college, had only time for a brief hello before going out to meet a friend. Relatives are welcomed, and several have close and frequent contact. The manager advised me that the service is about to employ a Family Liaison Officer to work the work with families of people living at Patricia House. One person living at the home was keen to tell me of the people they had met in various clubs, and how they had particular friends. Their only regret was that they had lost contact with a few people they used to be friends with at a social club when they had lived in a previous home. The manager agreed it would be a good idea to try to re-establish contact with those people. Staff worked and spoke with people living at the home in a warm, relaxed, and respectful way. People are encouraged to eat a healthy and varied diet, while being given choices. One person was pleased to tell of the progress they are making in preparing food, saying they had prepared a jacket potato by themselves yesterday. One person was supported to eat a freshly prepared, nutritious lunch as independently as possible. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from staff that understand their health and personal care needs, and from a service that ensures that they are met in ways that enhances their personal choice and independence. They can be confident that any shortfall in medication recording is swiftly addressed. Evidence: Staff showed themselves, in discussion and in interactions with individual residents, to be knowledgeable about individual needs and wishes and how to meet them. A resident spoken with was full of praise for the way they had been helped to do more things independently since moving to Patricia House. Interactions showed staff helping residents and motivating them to be independent, whilst still offering choice and support. Each person living at Patricia House has their own health action plan, detailing individual health needs and how they are met. There was evidence in care plans of the involvement of behavioural specialists, speech and language therapists, and other health professionals. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: The administration and recording of medication was looked at. Controlled Medication was properly and securely stored and records kept in the appropriate register. The majority of medication is dispensed via blister packs, and checking of samples showed this to be dispensed and recorded accurately. Of those medications not dispensed by blister or Monitored Dosage System, two had, as well as Medication Administration Record Sheets, separate sheets which effectively stock controlled their use by counting down amounts left. These were accurate. One medication did not, however, and it was difficult to work out whether the amount left tallied with what had been dispensed. It appeared not to, but, following the inspection, the manager faxed additions to the record which she believed showed that the record was in fact correct. The manager immediately instigated a stock control record for this medication similar to that used for the other two medications, to ensure that there was no uncertainty in future. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that they are listened to, and that the service takes seriously any complaints. The service protects them against abusive practices with policies and procedures and an aware staff team. Evidence: There has been one anonymous complaint made to us about the service over the past year. This was passed on to the provider of the service who fully investigated the issues raised and responded satisfactorily. The complaint log kept by the home showed one complaint made over the past year, and this too had been responded to appropriately. Relatives spoken with were happy with the service. One said that they always raised issues of concern with the staff or management, and felt that they were responded to. Staff were attentive and sensitive to residents wishes, even when these were not clearly articulated. One person was pleased, he told me, because staff supported him to do things that he wanted, and listened to him, even if they did not always agree. Records were seen of residents meetings, where residents raised issues of concern, or were encouraged to think about subjects such as where they would like to go for Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: holidays. Staff were clear on what to do if abuse of any sort was suspected. Policies and procedures in respect of this continue to be in place. Body maps are in individual files to record bruises, and staff were clear about their use, and what marks and bruises could give cause for concern. Arrangements for looking after residents finances continue to be satisfactory. A sample of monies looked after on behalf of residents was examined, and this was accurate, with expenditure accounted for. The manager explained the checks employed. These included random checks by the person who visits on behalf of the provider of the service. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a clean, comfortable and spacious home that allows people their own individual space, and to spend time with others if wished. Evidence: Patricia House is a large, roomy house in keeping with others nearby. There are two rooms downstairs suited for those with some mobility difficulties, and three bedrooms upstairs. All bedrooms have en suite facilities, so they can have showers. There is also a bathroom, for anyone who wishes to have a bath. Bedrooms are personalised according to individual wishes. One resident is obviously a football fan. Furnishings and fittings were well maintained, and everywhere was clean and fresh. One resident said how they found the house much easier to get around, and compared it favourably to their previous home. The front door has a key code, to provide security for those residents who may need it from the busy road outside. One resident, who is able to travel with some independence, is able to operate the key pad. The garden is now accessible to all, following the installation of a ramp. Care Homes for Adults (18-65 years) Page 21 of 30 Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from the attentions of a properly recruited and trained staff team, who are familiar with and knowledgeable about the residents. There are sufficient staff to be able to support residents as diverse individuals, and meet their differing individuals needs. Evidence: There were sufficient staff on duty to ensure residents individual needs were met, and the rota indicated that the service maintained a sufficient number of staff at all times. One relative commented that there were always enough staff, adding that they thought the staff were really good. A key worker system is in operation, whereby a particular staff has a particular responsibility to ensure that the needs of the person they are working with has their needs met. One person confidently told me who their key worker was. The manager and other staff advised that they do not use agency staff. On the day of the inspection, there was one bank staff, who has worked consistently for the service and was familiar with the residents and their needs. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Staff spoken with were happy that training helped equip them and support them in their work. The majority have National Vocational Qualification level 3 or are working towards it. Staff have mandatory training, and training in relevant areas such as autism. One staff expressed a wish for further training in supporting people with a visual impairment. Records, and discussion with staff, showed that staff receive a suitable induction programme when first appointed. A sample of two staff files were looked at. These showed that staff are properly recruited, with evidence of satisfactory Criminal Records Bureau checks and references. Staff were observed throughout to interact with residents in a warm, easy-going manner, whilst always being respectful, and all were comfortable and familiar with each other. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Patricia House benefit from a well-run home that promotes their overall well-being, health and safety, and strives to improve, and supports them in increasing their skills. Evidence: At present, the operations manager for the organisation is acting as manager for Patricia House. Staff and relatives both remarked how much more stable the home has been in the last six months or so, following a lot of changes in staff. Where shortcomings in the home were noted, the manager was prompt and effective in addressing them. The home has a very positive ethos, whereby sufficient numbers of knowledgeable staff support residents in gaining and increasing skills that help them further their independence in relevant ways, whether it be in social skills, self-care, communication, or cooking. Relatives commented on improved communication, as well as a wider experience of activities. Comments from residents included: I am learning here. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Regular visits take place by a person representing the registered provider, who provides a report of areas they have looked at, with any area for improvement noted. Records of residents meetings were seen, showing items of interest and concern being discussed. Hazardous items were stored safely, and the environment was kept safe and in a good state of repair, with no obvious hazards noted, except for the fire door as noted below. One fire door was kept open by a wedge. The manager was advised that this was not acceptable, and the wedge was removed. The manager advised the following day that an appropriate closure device had been ordered. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 There must be always be a full risk assessment in place regarding any need for, and use of, bed rails. This helps ensure that people using such aids do so for valid reasons, and are safe with them. 17/03/2009 2 20 13 The service must ensure that all medication is accurately and clearly stock controlled This is so that people living at the home can be fully confident that all medications are administered and recorded properly. 17/03/2009 3 42 23 Fire doors must only be kept 17/03/2009 open by appropriate devices that will close automatically in the event of fire alarms activating. Care Homes for Adults (18-65 years) Page 28 of 30 This is so that the safety of people living in the home is not compromised. 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 6 All guidelines for individuals should be dated and signed where appropriate, to help ensure that the guidelines for meeting individual needs are to up to date and that it is clear who helped to establish those guidelines. The service should consider supporting a resident in trying to regain contact with some people they had lost touch with following the move to Patricia House. More training in supporting people with a visual impairment is recommended. 2 15 3 35 Care Homes for Adults (18-65 years) Page 29 of 30 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). 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