Inspection on 30/09/08 for Rogate

This inspection was carried out on 30th September 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rogate 21/11/06

Rogate 06/03/06

Rogate 16/05/05

Rogate 06/10/04

Rogate 05/05/04

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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: Rogate 63 Surrenden Road Brighton East Sussex BN1 6PQ     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: Nigel Thompson     Date: 3 0 0 9 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: Rogate 63 Surrenden Road Brighton East Sussex BN1 6PQ 01273561685 01273552626 admin@rogate.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Nancy Jane Stembridge Type of registration: Number of places registered: Hallcreed Limited care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 12. The registered person may provide the following category/ies of service only Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Rogate is registered to accommodate up to twelve people with learning disabilities; it does not provide nursing care. The home is situated in a pleasant residential area of Brighton, close to local parks, shops and pubs. It is convenient for bus services into Brighton and Preston Park train station is also nearby. The building is a four-storey Edwardian house retaining some original features. The basement area has a games room and a covered hydrotherapy pool with a ramp. There are also changing and shower facilities available and a lift from these facilities to the pool. The home is fitted with ramps to enable wheelchair access, and a sloping path leads down to the pool and Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 12 Brief description of the care home the large back garden where there is a barbecue area. The sitting room, dining room and some bedrooms are on the ground floor, and the home is therefore suitable for wheelchair users. Information about the service, including the Statement of Purpose, Service Users Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. 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 unannounced inspection took place over five hours in September 2008. It found that all of the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were eleven service users living at the home. Care Homes for Adults (18-65 years) Page 6 of 30 The inspection involved a tour of the premises, observation of working practices, examination of the home’s records and discussion with two service users, three members of staff and the recently appointed Consultant - Care Services (Manager) Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. The focus of the inspection was on the quality of life for people who live at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Adults (18-65 years) Page 8 of 30 240 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The comprehensive admission policy and procedure ensure that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users know that the home is able to meet their individual care and support needs. Evidence: Information is available to prospective and existing service users in various formats. The Statement of Purpose and Service User Guide have been thoughtfully and imaginatively produced with the use of pictures and symbols and are both comprehensive and informative. It is evident that both documents have recently been reviewed and updated to reflect organisational changes in the mangement structure. As part of the home’s admission procedure, the manager (Consultant - Care Services) confirmed that, following a referral to the home, she would carry out a thorough needs assessment including pen portrait and risk assessment. A detailed pre-admission assessment form has been developed and includes information relating to the Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: individual’s personal, medical, social and psychological care and support needs. It was noted that, with the exception of one successful respite placement, there have been no admissions to the home since the previous inspection. Prospective service users and their relatives are encouraged to visit the home and have the opportunity to look around and meet with members of staff and existing residents. Having moved into the home, the manager confirmed that service users undergo a ‘flexible’ trial period, during which time their suitability and compatibility are assessed and it is established whether their identified care and support needs are able to be met. 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. Comprehensive care plans enable staff to meet the assessed support needs of service users in a structured and consistent manner. Systems for consultation and participation are effective. Service users are treated with respect and encouraged and enabled to make decisions about their day-to-day living. Evidence: Satisfactory care plans have been developed for each service user, clearly linked to the individual’s assessed needs. The plan is formulated by the key-worker, manager and evidently with the direct involvement of the service user or family member, as appropriate. Staff spoken to during the inspection confirmed that, despite the variable and limited verbal communication of the majority of service users, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting service users in a professional, sensitive and Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: respectful manner. The manager confirmed that all service users’ care plans, which she described as working documents have recently been reviewed to ensure that the individual’s care and support needs continue to be met in a structured and consistent manner. Routinely involved in this review are evidently the service user, family member (in accordance with the wishes of the service user), key worker, manager and representatives from the day centre and the Community Learning Disability Team (CLDT). This was supported through discussions with service users and staff and from individual care plans that were examined. The manager confirmed that individual Person Centred Plans (PCPs) are in the process of being developed and implemented for each service user. The Day Services Manager is evidently coordinating this transition to more user focussed care planning. 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. Service users are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Service users benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. Evidence: Staff spoken with during th inspection confirmed that service users are encouraged and supported to make decisions about their day-to-day living and there was evidence of effective consultation systems being in place. Individuals are clearly consulted regarding many aspects of their day-to-day living, including menu planning and choosing both individual and collective social, recreational and leisure activities. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Staff confirmed that visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. Where appropriate, and in accordance with their wishes, service users’ family links are supported, however not all service users have regular family contact. Community participation is evidently a focus in the home. Sufficient numbers of staff help ensure that service users are enabled and supported to visit local shops, cafes and other amenities. The recreational and leisure interests of service users are identified and recorded in their individual care plan and individuals are enabled to access activities and facilities, reflecting their individual needs, preferences and abilities. Service users at Rogate continue to attend local day centres, five days a week. They are accompanied and supported in various activities, including bowling sculpturing and reading, by care staff from the home, working on the early shift. Another significant resource which service users are enabled to access is the hydrotherapy pool at the rear of the premises. On the day of the inspection two service users, closely supported by care staff, were clearly enjoying their session in the water. Menus which were examined were found to be varied, balanced and nutritious and are evidently based on service users’ identified likes and preferences. An alternative to the main meal is always available. Howevr as discussed with the manager and staff during the inspection, for the benefit of service users with limited communication, it is recommended that consideration be given to the use of photographs and pictures, to help bring the menus to life. A member of staff, spoken with during the inspection, confirmed that service users’ likes and dislikes are recorded and they are regularly consulted regarding menu planning. He added that, where practicable and in accordance with their wishes, service users are supported in the kitchen to assist staff with meal preparation. This was evidenced by one service user, spoken with during the inspection: ‘The food is good here and they ask us what we like’. 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. Staff have developed close and positive relationships with service users and demonstrate an awareness and sound understanding of their individual care and support needs. Service users are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. Evidence: As previously documented staff have developed close working relationships with individual service users. With improved staffing levels within the home this is now often on a one to one situation. In accordance with their personal care plan, service users are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, service users were observed being supported in a sensitive, professional and respectful manner by members of staff. Documentary evidence was in place to demonstrate that the health and emotional care Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: needs of service users continue to be met within the home. All service users are registered with local GPs and have access to other health care professionals, including district nurses, physiotherapists and dentists, as required. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. The manager confirmed that the home enjoys a very positive working relationship with the multi disciplinary team based at Denmark Villas, who provide invaluable support and guidance. Over recent months service users and staff have recieved support from the Behavioural Team, Occupational Therapists, the psychology and psychiatry departments, dieticians and physiotherapy. Specific input has also been provided by the Speech and Language Therapists (SALT) in respect of a service user who is now on a blended food diet. Improved, up to date and detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. The home uses a monitored dosage system (MDS) for the administration of prescribed medicines and a local pharmacist continues to carry out regular monitoring visits. The manager confirmed that all staff responsible for administering medication have received appropriate training and are individually assessed and authorised to do so. This was confirmed through discussions with staff and supported by training records examined. 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. The home’s complaints procedure ensures that service users, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Service users are protected, through policies and procedures relating to abuse and adult protection. Evidence: The organisation has produced a complaints policy and procedure, as part of the Statement of Purpose and Service User Guide. Service users and members of staff, spoken with during the inspection, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. However it was noted that there is currently no accessible complaints procedure in place, for the benefit of service users’ relatives or other visitors to the home. Therefore, following discussion with the manager, it is recommended that a copy of the complaints procedure be reinstated in the entrance hall. The organisation has produced detailed policies and procedures relating to protection and abuse, including a whistle blowing policy. The manager confirmed that all staff have recently undertaken safeguarding vulnerable adults training, in accordance with Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: the revised multi agency guidelines. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. 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. The service is accessible, safe and clean and remains clearly suitable for it’s stated purpose. Service users benefit from all necessary specialist equipment and pleasant accommodation that is comfortable and, with the exception of the kitchen, well maintained and decorated to a satisfactory standard. Evidence: During my ‘guided tour’ of the premises it was evident that the generally well maintained décor and adequate furniture and furnishings continue to provide a comfortable, safe and pleasant environment for service users. The manager confirmed that independence and individuality continue to be promoted within the home and this is evident from the personalising of service users’ rooms, reflecting individual taste, preference and interests. Identified maintenance requirements are evidently documented and addressed, as necessary. However it was noted that in the kitchen the radiator is rusty and the walls and paintwork are looking ‘tired’ and in need of redecorating and generally ‘freshening up’. The work surfaces, cabinets, certain appliances and the floor covering are also in a poor condition and need replacing. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Following discussion with the manager, who herself described the kitchen and dining area as looking tired and shabby, the kitchen is be refurbished. It will also be necessary, as discusssed, to replace the torn and stained carpet in a service users bedroom. Infection control policies and procedures are in place and clearly adhered to and, on the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be generally satisfactory. 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. There is always sufficient trained and competent staff on duty to meet the assessed needs of the service users. Service users are protected by satisfactory staff recruitment policies, procedures and documentation. Evidence: There is evidently sufficient staff on duty at all times to meet the current assessed care and support needs of the service users. The rota indicated that there is a minimum of four staff employed mornings and evenings, with one waking member of staff and two people sleeping in each night. Following discussion with the manager it is recommended that the rota be amended to include the designation of each member of staff. The manager and Training Officer clearly recognise the importance of a skilled and competent workforce. A training matrix has been developed and implemented and it was noted that all new staff receive comprehensive induction and foundation training, the ‘Common Induction Standard’, which is compatible with Skills for Care (Formerly TOPSS). Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: In addition to this programme, appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and supported by training records examined: ‘There is plenty of opportunity for training here.’ Since the previous inspection, as required, and in accordance with company policy, the manager confirmed that formal supervision is now provided for all care staff on a regular basis. The Training Officer evidently has responsibility for supervising the shift leaders across the organistion and the manager supervises all home managers and support staff. All supervision sessions are appropriately recorded. It was also noted that each member of staff receives and signs a supervision contract detailing the agreed conditions. Through direct observation and discussions with members of staff, it is evident that the manager also operates an ‘open door’ policy, with staff feeling confident and able to discuss any issues at anytime. The home evidently operates thorough and robust recruitment procedures, to ensure the protection of service users. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. 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. Service users benefit from a competent and experienced manager and are protected by satisfactory health and safety procedures. Their best interests are safeguarded by adequate and effective quality monitoring systems. Evidence: The experienced and competent manager (Consultant - Care Services) has been in her current post since November 2007. She was previously employed by the organisation as a registered Care Services Manager from June 1999 to May 2006. She has extensive and relevant experience of managing services for adults with learning disabilities and has obtained the National Vocational Qualification (NVQ) level 4 in Management and Care. She is also an accredited NVQ Assessor. From direct observation and through discussions with service users and members of staff, it is evident that the manager demonstrates a clear and positive sense of leadership and direction. She is conscientious, motivated and approachable. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: The home operates effective quality monitoring systems, including satisfaction questionnaires, (What do you think?) for service users, their relatives, advocates and other visitors to the home. Positive responses from the most recent survey indicate a high degree of satisfaction with the home and the services provided: I couldnt hope for anywhere better for....... I can relax knowing that he is well loved and cared for. I am very pleased and grateful with the way she has been looked after. I would recommend anyone in our position, with a special needs relation, to have them stay at this home. Thank you. The manager confirmed that the health, safety and welfare of service users and staff remains of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. 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 24 23 All areas of the home, including the kitchen, to be kept well maintained and reasonably decorated. Kitchen radiator is rusty and walls and paintwork looking ‘tired and shabby. Work surfaces, cabinets, certain appliances and the floor covering are also in a poor condition. 19/12/2008 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 17 For the benefit of the many service users in the home with limited communication, it is recommended that consideration be given to the use of photographs and pictures, to help bring the menus to life. For the benefit of service users relatives and other visitors to the home, it is recommended that a copy of the complaints procedure be reinstated in the entrance hall. It is recommended that, as discusssed with the manager, the torn and stained carpet in a service users bedroom should now be replaced. Page 28 of 30 2 22 3 24 Care Homes for Adults (18-65 years) 4 33 It is recommended that the duty rota be amended to include the designation of each member of staff. 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). 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