Inspection on 13/11/08 for Stapleton Drive

This inspection was carried out on 13th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Stapleton Drive 25 - 29 Stapleton Drive Chelmsley Wood Birmingham West Midlands B37 5LQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Preston     Date: 1 3 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Stapleton Drive 25 - 29 Stapleton Drive Chelmsley Wood Birmingham West Midlands B37 5LQ 01217702469 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Solihull Care Trust Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 12 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 12 The maximum number of service users to accommodated is 12. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 12 Date of last inspection Brief description of the care home Stapleton Drive consists of three separate houses that provide care and accommodation to up to four people with a learning disability in each house. The home is situated in the Chelmsley Wood area of Solihull and there are shops, pubs, places of worship and public transport links nearby. People have their own bedroom and share kitchens, lounges and dining areas as well as bathroom facilities. One bedroom has an en suite shower and toilet. There are car parking spaces at the front of the houses and Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home gardens to the rear. We did not have access to information about the fees charged to live in the home at this visit. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This visit took place over one day. The people who live and work at the home did not know that we were coming. This was the homes first inspection since a new person was appointed as a responsible individual earlier this year. Before our visit took place we looked at notifications that the home had sent us which informed us of any events that had impacted on the health and well being of the people who live there. We also reviewed the homes Annual Quality Assurance Assessment (AQAA). This is a document that staff at the home complete which gives us information about how they are meeting national minimum standards, details about the staffing of the home, the policies and procedures in place to make sure that people stay safe and well and how the home plans to make improvements to the service Care Homes for Adults (18-65 years) Page 6 of 32 delivered. We case tracked three people who live in the home. Case tracking involves meeting or observing people, reviewing records of their care and talking to the staff who support them in order to focus on outcomes. Case tracking helps us understand the experiences of people who live in the home. We looked at the way medicines and health and safety were being managed, observed the environment that people live in and reviewed staff training and recruitment records. The newly appointed manager was present at this visit and helped answer our questions about the running of the home. We met all of the people who live in the home and spent time talking to four of them. This helped us gather information about their views and opinions of the service they receive. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 32 Care Homes for Adults (18-65 years) Page 9 of 32 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 32 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 who live in the home have access to information about the services and facilities provided there. Systems are in place to assess peoples needs before they move into the home so that they can be confident their needs will be met. Evidence: There have been no new people admitted to the home since the last inspection. The home has a system of assessing peoples needs before they move in. We looked at the procedure used for assessment and found it to be comprehensive. The manager told us that assessments are also provided by social workers and health care professionals so that people can be confident their needs will be met by the home. There is a statement of purpose and service user guide that we were told is made available to people and their families. The service user guide is due to be reviewed by staff, led by a Speech and Language Therapist so that people have access to information about the home in a manner they can understand. Care Homes for Adults (18-65 years) Page 11 of 32 Care Homes for Adults (18-65 years) Page 12 of 32 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. The systems of care planning and risk assessment do not always ensure that peoples needs will be fully understood and met. Evidence: We looked at care plans and risk assessments for three people, one from each house. Care plans explain the support that people require to make sure that their needs are understood and met. The quality of information varied from being comprehensive and up to date to irregularly reviewed and inaccurate. For example, some risk assessments had not been reviewed since 2007, although the document stated that they should be subject to six monthly review. Other risk assessments had not been dated, which makes it difficult to establish that the information is relevant to peoples current needs. In some cases information about people was being recorded on mood charts, with no reason for the judgements that Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: were being made. We talked to the manager about this and she promptly removed the charts after establishing that they served no purpose. Information about the support that people need to communicate with others had not always been completed, which could lead to individuals needs not being met. There was, however, some detailed information about how to support people with specific health care needs that had been regularly reviewed so that peoples well being could be maintained. We spoke to three members of staff who work closely with the people whose records we looked at. Each member of staff demonstrated good knowledge and understanding of their needs and clearly know them well. There was some confusion about an incident that had taken place, which staff said should have resulted in the review of a persons risk assessment whilst out in the community. This had not been done and could have placed the person at risk of potential harm. The people who live in the home need support to manage their money. We looked at the records for three people. In two cases the records matched the amount of money held on peoples behalf and receipts had been kept to confirm the cash amounts withdrawn. One record showed a large cash withdrawal that had not been receipted or the reason for the withdrawal explained in writing. This does not ensure that peoples money is being well looked after for their ongoing protection. Care Homes for Adults (18-65 years) Page 14 of 32 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 are supported to make decisions about their lifestyles, which promotes their independence. People are offered a choice of meals that reflect their needs and preferences. Evidence: We looked at three peoples records to check that they have opportunities to do things they enjoy on a regular basis. We also spoke to four people that live in the home and four members of staff about the way that activities are planned. The records that we saw showed that peoples social and leisure preferences had been recorded. There were photographs and pictures displayed to remind people what they were doing each day. Staff told us that this had been done in partnership with Speech and Language Therapists who had assessed the best way to offer this information to Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: people. Some of the people who live in the home completed questionnaires that we sent to them. The four questionnaires that we received stated that people always choose what they want to do and have good support from staff to go out and do things they enjoy. We saw records which showed that people are included in planning the things they do each day. This indicates that people are being consulted about the way they spend their leisure time. One person told us that they really enjoyed going to college and another was looking forward to a trip to the gym. There were risk assessments within peoples records to make sure that they were not exposed to hazards whilst taking part in activities. The home is good at supporting people to keep in touch with their friends and relatives so that they do not lose relationships that are important to them. There is access to a telephone and people told us that their family members come and visit them. We saw people in each of the houses taking part in domestic tasks such as making hot drinks, doing laundry and choosing the evening meal. This indicates that people are included in the running of their home. Menus and records of food that people had eaten were looked at to make sure that people were being offered a balanced diet that met their needs and preferences. The records that we saw showed that people had been offered a choice of meal and that fresh food was readily available. Two people told us that they plan their menus and often go food shopping to choose ingredients, with the support of the staff team. The same two people told us that they enjoy the food at the home and had no complaints about the meals. Care Homes for Adults (18-65 years) Page 16 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems in place to meet peoples personal care needs so that they receive support in a way they like and need. Medicines are not always well managed, which could place people at risk of becoming unwell. Evidence: We looked at the personal and health care plans of three people, one from each house. There was some comprehensive information about how to support people with specific health care needs such as diabetes. The staff that we spoke to were knowledgeable about supporting people with diabetes and had clearly read and understood the plan. Staff training records showed that awareness training took place on a regular basis, which should ensure that staff understand the needs of people with diabetes. Each person had a personal care plan that described their preferred daily routines such as whether they liked a bath or a shower and the help they need to choose their clothes and buy toiletries and other personal items. We saw evidence in financial Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: records that people shop for their own clothes and toiletries as part of a regular routine. Health care records showed that people have access to professionals such as chiropodists, dentists, Speech and Language Therapists, Well Man clinics and their GP according to their needs. The records contained the outcome of each appointment so that up to date information about individuals health needs was available to the staff team. People at Stapleton Drive have a Health Action Plan. This is a document that describes the support and services a person needs to stay healthy and well. In some cases the plans had not been fully completed, which could lead to individual needs not being met. In one case a person whose plan stated they were at risk of falls had an undated risk assessment so it was not clear that it was relevant to their current needs. We looked at the way that medicines are managed within each of the houses. Photocopies of prescriptions had been kept, however there are no photocopying facilities in the home, which means that staff have to take time to travel to make copies of each prescription. Some people have medicines on an as required basis. There were written protocols in place to describe the circumstances under which the medicine should be offered so that people stay healthy and well. On two occasions medicines had not been signed for on the medication record. Staff told us that they believed one of the medicines had been discontinued and another refused by the person. This was not reflected on the administration records seen. Care Homes for Adults (18-65 years) Page 18 of 32 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. There are effective procedures in place to listen to and respond to complaints and to safeguard people from harm. Evidence: The complaints procedure is displayed within the home and included in the statement of purpose and service user guide, so that people know how to raise a complaint if they need to. We were told that the procedure is being reviewed to make it more accessible to people who live in the home. Three people that we spoke to said they would talk to staff if they were unhappy. This was also reflected in the questionnaires that were returned to us. The home has received one complaint which had been documented clearly and included details of the nature of the complaint and how it was resolved. It was evident that staff are following their own procedures in dealing with complaints. We saw that the home has an adult protection procedure in place, which means that staff have guidance to follow in the event of an allegation being made. There has been one allegation relating to the protection of vulnerable adults since our last visit. From the records that we looked at, staff had taken effective action to protect people living in the home in accordance with their procedural guidance. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: Some people who live in the home demonstrate behaviour that can be challenging and therefore requires specific intervention so that they and others remain safe. We saw evidence in training records that staff had completed training in safeguarding and those staff that we spoke to were able to describe the actions they would take to protect people living at Stapleton Drive. Care Homes for Adults (18-65 years) Page 20 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a homely, clean and comfortable place to live and their privacy is respected and maintained. Evidence: The home is situated in the Chelmsley Wood area of Solihull and is close to shops, restaurants, places of worship and public transport routes. This is important to the people who live in the home as they make regular use of these facilities. The home consists of three houses, which each have a separate garden at the rear. There is car parking space available at the front of the home. We looked around each of the houses and found that they were warm and clean. Bedrooms were highly personalised and people told us that they had a key to their bedroom door. One person said that this was very important as he liked to keep his room and belongings private. One of the houses had a new fitted kitchen and new carpets and sofas in the lounge. This enhanced the appearance of the home for the comfort of the people who live there. Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: Each house has a good sized kitchen, lounge and dining area with sufficient bathing facilities to meet the needs of the people who live there. Laundry areas were clean and tidy and there were measures in place to minimise the risk of cross infection from soiled linen. People told us, and it was reflected in the questionnaires we received that the home was always fresh and clean. Care Homes for Adults (18-65 years) Page 22 of 32 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 are supported by a well trained team of staff who have good understanding of their individual needs. The home operates a robust system of staff recruitment for the ongoing protection of the people who live there. Evidence: We spent time talking to people about the qualities of the staff team who work in the home and were told that they were good, kind and nice. Some people, who have complex communication needs, were not able to tell us their opinions, however from observation of their body language it was evident that they had made good relationships with the staff on duty. We looked at the homes rotas to make sure that there were enough staff on duty to meet the needs of the people who live there. There are usually three to four staff working during the day, with sleep in staff overnight. There is a waking night staff in one of the houses, who can be called upon in the event that they are needed. The three staff recruitment records that we looked at showed that appropriate checks Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: had been made to make sure that staff were suitably qualified and experienced to work with the people who live in the home. Criminal Records Bureau checks had been made and written references received prior to the employee beginning work so that people were protected from the risk of having unsuitable staff working with them. We saw that new staff had completed an induction to work, which included the principles of care, equality and diversity, health and safety and record keeping. The staff training records that we looked at demonstrated that a regular programme of training is made available which should contribute to the deployment of a trained and knowledgeable staff team. The staff that we spoke to were able to answer our questions about meeting the needs of the people who live in the home and have clearly got to know them well. The manager sent us an Annual Quality Assurance Assessment (AQAA) before we visited the home. This document stated that twenty three of the twenty seven staff employed had achieved or were working towards a National Vocational Qualification in care. This training should make sure that staff have the necessary knowledge and skills to care for people effectively. Care Homes for Adults (18-65 years) Page 24 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home does not always ensure that peoples views are listened to or that their health and safety is always promoted and protected. Evidence: The home has a new manager who was present during our visit. The manager said that she had received a handover from the previous post holder in order to get information about the needs of the people living in the home and to understand the systems in place with regard to day to day management. The new manager has eleven years experience working with people with a learning disability and has completed training that is appropriate to her role. A house leader is employed in each house to support the manager in the running of the home. We were shown a range of systems that are used to check the quality of the service provided within the home. The manager had recently completed a self assessment of Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: the standards maintained within the home, which had been issued by Solihull Care Trust. This should enable the staff team to focus on better outcomes for people and address any shortfalls in the service provided. We looked at reports of the visits made by representatives of the registered provider, which are called Regulation 26 reports. The visits should take place once a month and include information about the views of people living in the home so that improvements can be made as necessary. The most recent report was dated August 2008 and there was little evidence that peoples views had been sought as part of that visit. A number of checks are made to make sure that peoples health and safety is promoted and protected. We saw records that showed that water, fridge and freezer temperatures were checked on a regular basis to avoid the risk of accidents or harm. In one of the houses, the fire alarm system had not been tested for three weeks, so that it could not be evidenced it had been working properly during that period, although staff believed it had been. Within the same house the emergency lighting test record did not specify the actual date of testing, only the month, which does not provide an accurate record of checking the system. In one of the houses, a cupboard used to store hazardous substances had been left unlocked and the door was open. We were told that one person may be at risk as they would eat things that could harm them. Although, when pointed out, the cupboard was secured, the person could have been placed at risk of harm through this oversight. Staff training records showed that health and safety, infection control, fire safety and first aid training were offered on a regular basis. This should contribute to a safer environment for people to live in. We spoke to two people who live in the home about what they would do in the event that the fire alarm sounded. They were able to tell us where to evacuate and where to assemble and confirmed that they practiced this every few months. The home has developed a disaster plan, that we were told would be used in the event that people had to evacuate their home for a period of time. The document did not identify how to support individuals or describe the resources that would be needed to maintain peoples health and safety should the need to evacuate occur. The manager said that the plan would be reviewed. Care Homes for Adults (18-65 years) Page 26 of 32 Care Homes for Adults (18-65 years) Page 27 of 32 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 28 of 32 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 6 15 Each person must have a plan of care which explains how their needs with regard to health and welfare are to be met. This will make sure that people receive the care they need to stay healthy and well. 30/04/2009 2 9 13 Risk assessments must be completed for each person, where there are known hazards and subject to regular review. To ensure that people are protected from unreasonable risks and to promote their health and safety. 30/04/2009 3 20 13 Medicines must be signed for on the administration record when they are given. This will ensure that people receive their medication as prescribed. 21/03/2009 Care Homes for Adults (18-65 years) Page 29 of 32 4 20 13 Medication records must accurately reflect the medicines prescribed to each person. This will ensure that people receive their medication as prescribed. 21/03/2009 5 39 26 A representative of the registered provider must visit the home in order to report upon the quality of service provided within the home. To ensure that peoples views are sought as a means of developing the service provided. 01/04/2009 6 42 13 Hazardous substances must 19/03/2009 be securely stored within the home. To avoid the risk of harm to the people who live there. 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 7 The system of checking financial records should be reviewed so that potential errors are identified promptly and to ensure that peoples money is looked after safely. Risk assessments should be dated so that it is clear they are relevant to peoples current needs. Risk assessments that relate to peoples health care should be dated so that it is clear that they are relevant to their current needs. Health Action Plans should be reveiwed to ensure that they are fully completed and reflective of peoples needs. 2 3 9 19 4 19 Care Homes for Adults (18-65 years) Page 30 of 32 5 20 Consideration should be given to providing accessible photocopying facilities so that there is a robust system of managing peoples medicines. The disaster planning document should be reviewed so that it clearly states the action to be taken to protect those who live in the home. The fire alarm testing records should be completed after each test has taken place to make sure that there is an accurate record of testing and to ensure it is in working order for the protection of people who live in the home. 6 42 7 42 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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