Inspection on 07/10/08 for Rainbow Lodge Nursing Home

This inspection was carried out on 7th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rainbow Lodge Nursing Home 13/12/06

Rainbow Lodge Nursing Home 07/11/05

Rainbow Lodge Nursing Home 29/06/05

Rainbow Lodge Nursing Home 18/11/04

Rainbow Lodge Nursing Home 28/06/04

Rainbow Lodge Nursing Home 09/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Rainbow Lodge Nursing Home 14 Madeley Road Ealing London W5 2LH     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: Robert Bond     Date: 0 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Rainbow Lodge Nursing Home 14 Madeley Road Ealing London W5 2LH 02089915060 02085671414 kenilworth28@yahoo.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Luce Argita Gopaul Type of registration: Number of places registered: Mr and Mrs Gopaul care home 20 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 service users who can be accommodated is: 20 The registered person may provide the following category of service only: Care Home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Rainbow Lodge is a nursing home for up to twenty younger adults who have a mental health problem. It is situated in a residential area of Ealing close to local facilities and transport. The property is on four levels but there is no lift. There are currently 5 single and 7 double bedrooms in use. The home has a large combined lounge and dining room, and a small communal quiet room that can be used also for meetings. There is a large secluded garden at the rear of the building and parking spaces for several cars in front of the home. The service is owned by Mr and Mrs Gopaul and they are the Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 20 Brief description of the care home Registered Providers. Mrs Gopaul is the Registered Manager. At the time of inspection the fees for the home were from £800 per week upwards. 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 was a key inspection that considered mainly the outcomes of the key National Minimum Standards as published by the Department of Health for care homes for younger adults. The CSCI inspector was assisted by an Expert by Experience inspector provided by the National Centre for Independent Living. We spent a full day at the care home during which time we interviewed the Proprietors, the Registered Manager, the Staff Nurse on duty, and the Administrator. The Expert by Experience talked at length with all of the residents. We toured the building, and the CSCI inspector case-tracked several care files, and examined a range of other documentation. Equality and diversity were considered throughout the inspection but no adverse issues came to light. Care Homes for Adults (18-65 years) Page 6 of 30 The home provided us with a completed Annual Quality Assurance Assessment (AQAA) in advance of the inspection. In total we considered the outcomes of 26 standards and found that 18 were fully met, and one was exceeded, whereas 7 were only partially met. This led to us making 8 requirements and 3 recommendations. What the care home does well: What has improved since the last inspection? What they could do better: At the present time the home has 7 double rooms, hence upto 14 residents out of a Care Homes for Adults (18-65 years) Page 8 of 30 complement of 19 are sharing a room. The Proprietor reported that the aim is to increase the number of single occupancies. In the meantime each resident who shares, or their representative, should sign and date an agreement to share. Some of the bedrooms are sparcely furnished and decorated. There is a lack of personalisation particularly in the shared rooms, which in the words of the Expert by Experience, could be denying residents their own personal sanctuary. She was also concerned by the lack of emphasis within the home upon rehabilitation and the promotion of independence. Thus although some residents do move out to enter supported living, or do return to live with relatives, this possibility is not specifically planned for within the individual care plans we saw, is not mentioned within the homes Statement of Purpose, and occupational therapy type staff are not employed by the home. Residents are not sufficiently enabled or encouraged to assist in the running of the home or looking after themselves by for example being able to make a hot drink or snack at any time. Links with the community and similar care homes are weak or nonexistent and a befriending scheme is suggested. Although record keeping is generally good, it can be improved by the avoidance of photocopied forms where the headings can no longer be easily read, and by using care files with dividers so that key documents can be quickly located. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Statement of Purpose is clear and well produced but does not include the aim of specifically preparing residents where appropriate for supported or independent living. The assessment process undertaken prior to new residents moving in is good. The agreements to share a bedroom are not always dated. Evidence: We examined the homes Statement of Purpose which makes reference to rehabilitation, maintaining independence, and promoting possibilities for residents to establish contacts beyond the home. The Expert by Experience however was concerned that the home tended to do things for residents as opposed to sufficiently faciltating self-help that might lead to moving out into supported living or independent living. We talked to the Proprietor about this and he confirmed that although Rainbow Lodge was a long term care home, supported living had been tried for some residents, and others had returned to live with their families. The Statement of Purpose therefore must include details of these other possible anticipated outcomes. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: We examined the care files of the two residents who had moved into the home most recently. We found that assessment information had been provided by the referring Councils or hospitals, for example an Occupational assessment had been provided by the local psychiatric hospital service making the referrral. We also found that additional assessments had been undertaken by staff from the care home before the residents had moved in. In one case, the new patient assessment form that had been completed was headed Kenilworth House (another care home owned by the same providers) and this heading had been crossed out and the name of Rainbow Lodge substituted. Neither of the care files examined contained a signed agreement to share a bedroom. An example we did see of this agreement had been signed by the resident but had not been dated. 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 know what is in their care plans and have been satisfactorily involved in drawing them up, but rehabilitation should be accorded an enhanced status within care planning. Residents are suitably involved in decision making concerning their lives but the promotion of independent lifestyles, including helping to run the care home, could be enhanced. Evidence: We examined the care files of the two residents who had most recently moved into the care home. The care files examined contained detailed care plans, the originals of which were dated the same date as the admission date. One example had been evaluated, that is reviewed, after the resident had been in the home for two weeks, and had been further reviewed every month thereafter. A number of different care plan topics were covered including smoking, social and recreational needs and mental capacity. Specific rehabilitation care plans were not seen although a rehabilitation programme form was noted which listed the activities undertaken by Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: that resident on a day to day basis. The residents key worker was named within the care plan documentation. The care of those residents subject to the Care Programme Approach (CPA), had been separately reviewed and documented. There was evidence on the care files that residents, and sometimes their relatives, were consulted about care plan contents. We observed that residents were also consulted about activities and meals for example at the weekly community meeting. A notice on the wall in the foyer advertised an advocacy service. We observed a community meeting taking place that was chaired by the Registered Manager, and we examined the minutes of two previous meetings. The care files contained risk assessments that were regularly reviewed. Residents were seen to be assisting in the operation of the home to some extent as a means to maintaining and promoting their independence but the Expert by Experience considered that greater promotion of independence should be taking place. The Proprietor sais that resiedents can make tea for themselves but are not allowed into the kitchen to do this between 10.30 and 12 noon due to a restriction made by the Environmental Health Department. 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. Although residents do leave the home to undertake a range of activities, the extent of visiting to the home by volunteers or professional activity based staff is very limited. Residents are provided with good meals. Evidence: Social and recreational needs were included in the care plans we examined but as has been said, rehabilitation is not specifically planned for in detail despite individual residents activities being recorded on a daily basis. The Proprietor spoke to us about the residents apathy and reluctance to attend day centres. However we saw no evidence of any visits to the home by occupational therapists or similar in order to provide individually assessed or group activities at the home. The home does however have a computer that residents can use and outings to places of interest do take place. The Proprietor said he was keen to have more community involvement in the home Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: such as an Open Day and we talked about whether Criminal Record Bureau checks would be a barrier to this, which it should not be. The Expert by Experience wrote in her report that residents could have more contact with the residents of similar homes. The Proprietor reported that none of the residents was in a relationship at the present time. None of the residents is in paid employment or voluntary employment, no one goes to college at present and only limited education takes place within the home. The Proprietor said that only one resident did not have any relations to visit but nevertheless we consider that there is good scope for a befriending scheme. We noted that staff knock on bedroom doors before entering, there is a pay phone in the hall, and residents are offered a room key and a lockable cabinet key if they want it. We observed the residents eating lunch, and the Expert by Experience shared the meal which she enjoyed. She wrote that residents are involved in drawing up the menu, which appears to be balanced and contains fresh fruit. She adds she would have liked to see residents more involved in food preparation however. One resident was seen to be washing up though. 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. Residents receive the assistance they need with personal care, but the emphasis seems to be more about provision of care as opposed to support to help residents gain independence. Residents health care needs are being met. Minor changes are necessary to the medication administration recording systems to ensure that residents are fully protected. Evidence: The care plans examined demonstrated that the key worker system is in place, and that the wishes of residents are taken into account when devising the contents of the care plans. The AQAA document refers to person-centred planning but the extent of this is limited to getting residents to sign their care plans according to the homes administrator, and as stated elsewhere, the promotion of independence is also limited. For example, the figures quoted in the AQAA claim that 336 care hours per week are used to provide personal care, whereas only 36 hours per week are used for support. This is a surprising statistic as the residents are said to be self-caring in terms of personal care. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: In terms of health, the care files contain weight charts, blood pressure charts, blood glucose monitoring charts where appropriate, and records of health (and social work) professional interventions. The AQAA refers to health action plans but the files seen did not contain specific documents so named. When questioned about it, the homes administrator said health education is promoted via meetings, and residents are encouraged to undertake keep fit exercises, and to eat healthily. The home employs its own nursing staff and some residents are subject to the Care Programme Approach. We checked a sample of the medication storage and administration records. All were found to be in order except for two points. The form for recording the disposal of unused medication was seen to be obsolete as it referred to disposal or destruction as the two options whereas all such medication is now collected as clinical waste. Medication administration is recorded on a form that has been photocopied so many times that it is impossible to read some of the headings. None of the residents are able to manage their own medication. 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. Residents and their relatives can feel assured that any complaints will be fully investigated and that residents are well protected by the homes established procedures and staff training. Evidence: We examined the homes complaints policy and procedure, which appears throughout the home, and we examined the homes complaints file. No complaints have been recorded by the home since before the previous CSCI inspection. During this same period no complaints have been made to the CSCI. No concerns or complaints were made to us during the inspection. On the contrary, several residents told us they were happy at the home. The home has not made any Safeguarding Adults referrals during the period in question, and the proprietor assured us that all staff have been trained in the procedures. The Proprietor told us that he is the appointee for one resident only. We checked the financial records of the money held by the home for this resident, which were in order. Care Homes for Adults (18-65 years) Page 19 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 live in a home that is safe, comfortable, clean, and hygenic but not always very homely. Evidence: We toured the care home and observed most areas, including almost of of the bedrooms, with residents permission. The home is newly decorated throughout. The Proprietor reported that residents chose the colour for their bedroom walls. New carpets have been laid in most areas. There are 5 single bedrooms and 7 double (shared) rooms. One shared room did not have a dividing screen, but this was subsequently produced as it was away being cleaned elsewhere in the building. The Proprietor has changed one double into a sinle room and intends to make further reductions in the number of double rooms. Not every resident has a lockable cabinet or equivalent, but the Proprietor said this reflected individual choice, and it was clear that the home does have sufficient lockable cabinets overall. New chairs have been purchased for the communal lounge dining room. There is a small quite room but it does not contain easy chairs only hard upright ones. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The home was seen to be clean and hygenic throughout with no malodours. The Expert by Experience noted that some light pull switches lacked toggles, and made the comment that it would be nice to have more art work on the walls. She added, some bedrooms appear homely whereas others do not and as these rooms are without personalisation, this issue could be denying residents their own personal sanctuary. Care Homes for Adults (18-65 years) Page 21 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. Residents are well looked after by a well trained staff group in sufficient numbers and who have been carefully recruited. Evidence: We examined the homes staffing roster which showed that sufficient care staff and nursing staff were deployed. The AQAA does not make mention of any social activity organisers or similar positions having been appointed. The AQAA states that the care staff are more involved in leading activities than they were previously. The AQAA also states that 47 of the care staff have NVQ awards and that the remaining care staff are working towards gaining those awards. The AQAA states that all staff have completed their mandatory training, and have been provided with mental health training. Some staff have also attended a conference on the Mental Capacity Act, and two staff are undertaking the Registered Managers Award. We noted examples of training plans and training records. We examined two recent staff recruitment files and found that all necessary checks had been undertaken, and a full induction completed. Care Homes for Adults (18-65 years) Page 22 of 30 Care Homes for Adults (18-65 years) Page 23 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. Residents benefit from a home that is well managed, and safe. Residents views and those of other stakeholders are collected. Some aspects of record keeping must be improved. Evidence: The Registered Manager is a qualified nurse, as is the other Proprietor of the home, who is the registered manager of the nearby Kenilworth House. Only one requirement was made following the last CSCI inspection, and that has been addressed. We examined minutes of staff meetings held. The home continues to be well managed. The home has a development plan that we saw, and quality assurance surveys are undertaken. We noted the following comments from the surveys. Residents said, I do like this place and love the staff. I like the food. I am happy living here. A relative said, Very good home and caring staff. A member of staff said, I always enjoy my Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: work and the team. The fact that staff are surveyed in addition to the usual stakeholders is commended. We had some difficulty finding the required documents within the care files as no dividers are used and a number of different documents are contained within the same envelope. Some forms have been photocopied so many times that headings are hard to read. We checked the hot water supply, temperature records, the operation of the call bell system, the gas safety certificate, and the most recent monthly health and safety audit. Care Homes for Adults (18-65 years) Page 25 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 26 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 1 4 The Statement of Purpose must be extended to give details of anticipated outcomes that might be achieved through rehabilitation and promotion of independence. This will provide purchasers of the service, potential residents and their relatives with additional information about the home, its aims and objectives. 30/11/2008 2 5 17 Every resident who shares a bedroom must sign, or have their representative sign, a dated agreement. This will demonstrate that residents have formally agreed to share a bedroom. 31/12/2008 3 6 15 Each residents care plan file 31/12/2008 must be reviewed to acertain whether additional individually assessed rehabilitation programmes Care Homes for Adults (18-65 years) Page 27 of 30 are indicated as being required. This will further promote residents independence, quality of life, and possibility of moving into supported living. 4 13 16 The home must foster greater links with the community. This would broaden the horizons of residents and possibly lead to new friendships. 5 20 13 The form for recording the disposal of unused medication must be updated. To avoid any doubt about how unused medication is dealt with. 6 20 13 The form used to record medication must be wholly legible. To assist staff to enter the required information in the correct section of the form so as to more fully protect residents from errors. 7 24 23 Ways must be found to increase the comfort and homeliness of the premises. This will enhance the experience of residents. 8 41 17 Improvements must be made to the care plan filing system. 31/12/2008 31/12/2008 30/11/2008 30/11/2008 31/12/2008 Care Homes for Adults (18-65 years) Page 28 of 30 Residents will be more easily able to access key documents from their files. 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 8 Further efforts should be made to involve residents in the operation of the care home by washing up, cleaning and shopping as a means to promote their independence and enhance their life skills. The possibility should be investigated to creating a kitchenette so that residents can make their own drinks and snacks at any time. It is recommended that the home develops a link with a voluntary organisation offering a befriending scheme. 2 8 3 15 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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