Inspection on 05/11/08 for Portland House Care Home

This inspection was carried out on 5th November 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

Portland House Care Home 10/08/06

Portland House Care Home 12/01/06

Portland House Care Home 12/09/05

Portland House Care Home 24/02/05

Portland House Care Home 15/09/04

Portland House Care Home 16/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Portland House Care Home 113 & 146 Portland Road Nottingham NG7 4HE     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: David Litchfield     Date: 0 5 1 1 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 © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Portland House Care Home 113 & 146 Portland Road Nottingham NG7 4HE 01159787840 01159789995 portlandhouse@activecarepartnerships.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: West Regent Ltd care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of services who can be accommodated is 27. The registered provider 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 category, Mental Disorder, Code MD Date of last inspection Brief description of the care home Portland House Care Home is registered to provide accommodation and care for up to twenty-seven younger adults with mental health needs across across two different buildings on opposite sides of Portland Road. Portland House is the larger home and Hemsley House is a smaller house providing support to four service users as a step towards independent living. The service is situated in a residential area close to Nottingham City Centre, and has good access to public transport, and community facilities. The fees for living at Portland House at the time of the inspection are £380.22 to £500 per week. 27 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: The last time we had visited this service was 10th August 2006. This unannounced inspection took place over one day in November 2008. We spent around eight hours at the service where we met the manager, staff and people who use the service. We asked the manager and staff about the service they provide to people, and about their knowledge and ability to do this. We looked in detail at the records of four people who use the service to find out about what information the service has about them, and where this came from. We looked at Care Homes for Adults (18-65 years) Page 5 of 29 how people are involved in agreeing the support they receive and how the service checks if they are still happy or if things have changed. We also looked at four staff files to check how the agency recruits its staff and makes sure that they are appropriately supervised and trained to provide support to people. We looked at the other records and information held by the service, such as how they keep people safe or how they respond to any complaints. We spoke with some people who use the service and asked them about their experience of the support they receive. We also used information we have received from the service since their last inspection and some surveys that people who use the service and staff have completed. 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. Care Homes for Adults (18-65 years) Page 7 of 29 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 are provided with information about the service and have their needs and expectations assessed. Evidence: We saw that there is information available about the service and a guide for people who are considering moving in. The manager showed us she has separate information about each of the two buildings where people live, and these tell people all about the service on offer, and how they can express their views. The manager told us that they are going to record the guides to help people who are unable to read the information easily. One person told us that they were not given enough information about the home, but another told us that they did have the information they needed. However, we did see the information was kept up-to-date and that the manager had records showing she checked monthly that it was still accurate. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: The service is registered to support people with mental health problems, although we saw that a small number have an additional learning disability. However, the manager has established that the main reason for using the service is for support with their mental health. Staff receive specialist training to support the people, with training in mental health and learning disabilities, and we heard there will be training around alcohol and substance abuse. We saw that peoples needs and expectations are considered before they start to receive a service. We saw very detailed records where they had asked for lots of information about people such as their health, their interests and how they communicate. We also saw that the service finds out about peoples life stories. We saw that they try to include the person in this process, but the manager told us that some people due to their health do not show an interest. In those case others such as social workers are central for the information. The manager told us that they expect people to visit first, and if they do not wish to do that, they consider them not to be interested in moving in. 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 adequate 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 where possible in the decisions about their lives, but it is not always recorded when they have chosen not to be. Not everyone has detailed plans covering the areas where they need support. Evidence: We saw that once peoples needs and expectations from the service are known, a plan is drawn up about the care they are to receive from staff. We saw that a separate plan is written for each area of support, like their health and behaviours. They were easy to follow and we saw that every month an assigned member of staff has the responsibility for checking they are correct and appropriate. We saw a signed record of this and in some cases the person using the service had signed also. The manager told us that when they are not signed it was because the person had not wanted to take part and in some cases a record was made of this refusal. There are records showing that the people and staff also meet with others such as Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: social workers to have more extensive discussions about their care. We saw that following these meetings, changes were sometimes needed to the plans and that these were put into place. For example one person needed a plan around alcohol use and we saw that the plan had been updated to cover this. A person who uses the service said the plans were alright but we saw that two different people needed support around personal care but they did not have plans telling staff how to do this. This is a recommendation we made at our last inspection that has not been followed. We saw that the service considers the risks people face in their daily lives, for example if people smoke outside of the designated areas, and these were again detailed and easy to follow. We saw that they were also kept up-to-date. Staff told us that risks are taken very seriously and that the manager always says write it in a risk assessment. We saw that peoples plans and risk assessments are mentioned in staff meetings, and saw that staff are expected to read and know all about peoples care. We spoke to staff about the plans and they said that the plans are a manual on how to care for the individual. We saw that people are supported to manage their finances and we confirmed that this was being managed responsibly. We saw that people can display behaviours that are difficult for the staff to manage. We saw that there are plans in place around how to cope and that people receive training from a certified trainer about this. Staff told us they will try to calm them down but always think about our own safety. The service does not use any form of physical restraint. We saw that people are given an opportunity to contribute to the home. There are monthly meetings for people who use the service and we saw a poster in the communal areas to let people know about these. Records are kept of the meetings and available for people to see. We saw that the meetings covered peoples responsibilities in the home but also provided an opportunity to raise any issues or ask questions. The manager told us these meetings are a chance for people to say if they are unhappy. 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 who use the service are able to make choices about their life style. Evidence: People told us that they can do what they want to do. One person attends college and records are kept of peoples daily activities, although the manager told us that in most cases people refuse to take part in any structured activities. We heard that one likes to paint and that there are computers for people to use. We also saw people playing pool. Others sat and watched TV, or smoked in the smoking room. The service until very recently had an activity coordinator, but since leaving the manager told us they have not been doing structured activities with people. We saw there is a notice board where people can sign up to some activities including a cinema trip. The manager said they had been on holiday last year for the first time, as Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: previously people had always refused to go. We saw records of what people have done, which were usually going out into the community independently. We also saw that records are kept about family members and contact with them recorded. The manager said they support people to stay in touch with people important to them. We saw the menus used for the meals prepared for people. One person told us that there is nice food and at the time of our visit the menus had been recently changed. A staff member told us that they had asked people what they like when creating the menus, but if people want something different on the day there are always alternatives. We saw that peoples dietary preferences are met such as vegetarians and that records are kept of what people chose and that they were free to do this. In the smaller of the two buildings we saw that people prepare their own food and are fully involved in the household. Staff told us people are supported to maintain the household wherever possible. In the main building, we heard people are less able to do this. We did see a room that we were told will be a kitchen for people to use and prepare their own food. 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 that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: We saw that peoples plans reflect the way they want to be supported, but as mentioned earlier some plans did not make it clear how certain needs were to be met, such as support with personal hygiene. This issue was pointed out in our previous inspection too. We saw peoples health needs have been planned for and are supported. Records are kept about any appointments they have and close contact is kept with the mental health professionals involved in peoples lives. We saw staff interacting with people who use the service and we saw people are treated with dignity. Staff told us we have to be patient and another said I treat them with respect. A person who uses the service said in a survey that staff are always kind and helpful and that staff usually act on what they say. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: We saw that staff checked with people that they were happy with what was happening, for example people were asked if they were happy to talk to us or to allow us to observe staff working with them. When they said no, we saw that people felt able to say no and that their wish was respected. We looked at the way peoples medication was administered. We saw that in some cases people are able to support themselves appropriately and that this was part of their plan. For those supported by the service, we saw that staff are trained around how to administer the medication and we observed it being administered responsibly. We checked that the records were accurate and saw that this was mostly the case. There was an example where the quantity had been mis-recorded on one sheet, although older records confirmed that all the medication could be accounted for correctly. We saw records from a staff meeting where staff had been reminded to ensure that medication is managed correctly. 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 receive a responsive service that acts to protect people from abuse and harm, and they benefit from a response complaints system but one that may not be easily accessible to everyone. Evidence: We looked at the way complaints are managed. We saw they have a policy about this, and while up-to-date, it requires complaints to be put into writing. We asked the manager how people unable or unwilling to write could make a complaint and she said she felt the policy was too restrictive. However, she told usshe is happy to receive complaints in any form including a verbal complaint. She showed us that this is the case with records about verbal complaints they had received. We saw that each concern had been looked at by the manager with a full record of the decisions and actions taken. We saw they had always let the complainant know what the outcomes were. We asked the manager about any complaints made by people who use the service. We were told that these would be recorded in their daily notes and not through the complaints policy. They are given information about how to complain in their guide, but again this tells them to put it in writing. People did tell us they would tell staff if unhappy, although not all said they knew how to complain. We saw people interacting with staff, and that staff were happy to listen to what people had to say. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: We looked at how the service keeps people safe from the risk of abuse. We saw that all staff had received training in this area, one telling us that training makes you very aware and they all showed they knew what to do. One told us that she had reported a concern about bruises once to a manager but records showed that these could be fully accounted for. We saw that they have asked the local authority to investigate some situations of aggression that had occurred between people using the service. We heard that social workers had provided support in situations such as this, but the local authority has not undertaken any investigations since our last visit. We saw records are kept of any request for the local authority to investigate and the manager has always lets us know about any concerns. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a good-sized home that is maintained on an ongoing basis but in parts it is not particularly homely. Evidence: There are two buildings forming the service. One of these is large with a range of communal spaces including a smoking room, large lounge and games area, and a dining room. On the whole communal areas were fairly tidy and comfortable, but in other parts of the building the carpets did not appear clean at the time of the inspection and its decoration looked considerably tired. In particular the corridors and landing areas were very bare and unhomely. In one part of the building we noticed a strong smell of urine. We heard from a person using the service that the home was clean but not always fresh The second, smaller building was better kept and much more homely in appearance. It had plenty of space, was much cleaner and had a brighter and more comfortable feel. We noted that smoking had occurred outside of the designated areas, including in people bedrooms. The manager told us that they do all possible to avoid this Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: happening, and we saw it was part of peoples plans to make regular checks to discourage people from doing this. There are suitable laundry facilities, and we saw staff are trained in controlling infections. We saw that gloves and other equipment is available to ensure this. We heard from the manager and staff that it is very difficult to maintain the household due to the nature of the people that use the service. A staff member told us the environment could be better. We saw that there is a full-time maintenance person, and that home maintenance is an ongoing process. We saw records that staff use to record things that need resolving, and that a record is then kept of when and how it was fixed. We saw that improvements have been made including new flooring in places. We looked at some peoples bedrooms. We saw that these are individualised to peoples tastes. Many are en-suite, and for those that dont there are sufficient bathrooms. 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. People receive a service from well-trained and supported staff. Evidence: We looked at the records kept about the way staff were employed and saw that all the correct checks are made like looking into any criminal background and getting references. We saw that staff are interviewed carefully and they check if people have the skills and knowledge to do the job. We saw the service gives new staff special training and information when they first start. Staff told us this process covers how to go about the job and that they are given a job description. We saw they are instructed around a number of subject areas and these are signed as they complete them. The information covers things like their responsibilities, how to communicate with people and how to keep their information safely. We saw that people then continue to receive lots of training around things like health and safety, how to control infection and how to plan peoples care. We also saw that people receive special training around mental health and learning disabilities to be better able to support the particular people who use the service. Peoples differences Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: are also recognised through special training where the manager said there was a focus on support staff to raise their awareness about their own prejudices and to recognise that other people have different views. Some of the training is carried out by other workers within the organisation and we saw that they have qualifications to do this. Staff told us that that they are well trained and that training is part of the contract. We saw that there are systems to make sure peoples training is up-to-date. We asked a person who uses the service about the ability of staff and were told that staff do a good job. We saw that staff receive support from the manager. We saw records kept of these covering both issues around the people using the service and staff matters. Staff said that they are asked if I have any problems, how Im going about the job and if I think Im supported or confident enough. We saw that there are consistent staffing levels. At our last inspection we told the manager to check the staffing levels were enough at the smaller building. On this visit, we saw that this had been done, and that a small increase had been made as a result. 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 receive a well-managed service. Evidence: We saw that the manager has kept her training up-to-date, some of which qualifies her to train staff. Staff told us they are happy with the management and a person who uses the service said that she is alright. We saw that the manager has a number of systems in place to check on the quality of the service. Every two months there is a full check of the home which looks at things like the records, health and safety and other matters. We saw that after this is finished, the manager decides what actions she needs to take. We could see that some of these actions had been taken, for example changes to the environment, but there was no record of exactly what was done or when. We saw that there are regular unannounced visits made by a senior person in the organisation and that the manager has a list of things she will do after each one. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: However, there was again no clear record of when these were done. We saw that there are systems to keep the environment safe. Each month there is a health and safety meeting, where the manager and other staff discuss any issues including any accidents to see if there are any patterns or actions that need to be taken. We saw that accidents are recorded. We also saw that any serious incidents are recorded, and that the manager now always tells us about each one shortly afterwards. We saw that there are regular checks and activities to keep people safe in the event of fire. We also saw that there are records of extensive maintenance checks throughout the building to ensure people are safe. We saw that there were a large number of policies covering different areas and responsibilities. These policies are shared across this and other services within the organisation. However, we noticed that many of these had not been checked since January 2006 to see if they were still appropriate and up-to-date. The manager told us she also believed they needed up-dating but that policies were not under her direct control. 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 6 When there is an identified need, a person should have a plan for how the service will meet that need. This will ensure that staff support people the way they want and need to be supported. If people decline to be involved in planning or reviewing their support this should be recorded. This means people can be confident that they will always be given the opportunity to make decisions about their lives. There should be ongoing activities available to people and a record kept if they choose not to take part. This will ensure that people continue to have the chance to develop their life and leisure opportunities. The service should ensure that medication records accurately reflect the amount of medication held for that person. This will ensure that peoples medication is administered safely. The complaints procedure should reflect peoples right to make complaints who do not use writing as a means of communication. This would ensure that all people including people who use the service feel entitled and able to express their views about the service. The home should be cheerful and free from offensive odours. This will ensure people live in a homely, Page 27 of 29 2 7 3 14 4 20 5 22 6 24 Care Homes for Adults (18-65 years) comfortable environment. 7 39 When there has been an identified need for the manager to resolve something, there should be a record of the actions taken. This will ensure that people benefit from a service that responds to any issues and continually improves. The policies should be reviewed, and then updated where appropriate. This will ensure that people receive support from staff who fully understand their current responsibilities. 8 40 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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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