Inspection on 20/02/09 for The Foam

This inspection was carried out on 20th February 2009.

CSCI found this care home to be providing an Adequate 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

The Foam 21/03/08

The Foam 06/07/06

The Foam 18/01/06

The Foam 01/09/05

The Foam 08/02/05

The Foam 31/08/04

The Foam 24/02/04

The Foam 31/01/03

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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: The Foam Chapel Road Dymchurch Romney Marsh Kent TN29 0TD     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: Kim Rogers     Date: 2 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: The Foam Chapel Road Dymchurch Romney Marsh Kent TN29 0TD 01303875151 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Parkcare Homes Ltd Name of registered manager (if applicable) Mrs Caroline Davies Type of registration: Number of places registered: 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 3. 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 The Foam is registered as a Care home providing 24 hour care and support for up to three people with a learning disability. Craegmoor Healthcare (ParkCare Homes no 2) is the registered provider. The manager has applied to be the registered manager and is currently going through the fit person process. The home is a detached bungalow in a residential area of Dymchurch. The accommodation comprises of three bedrooms, a lounge /diner, kitchen, and bathroom. Care Homes for Adults (18-65 years) Page 4 of 31 care home 3 Over 65 0 3 Brief description of the care home There is a small office which doubles as a staff sleep in room. Weekly charges range from about £905 and £1195.88. For more information about the fees and services please contact the Provider. Care Homes for Adults (18-65 years) Page 5 of 31 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 was a key inspection of the service and included an unannounced site visit by one inspector. The site visit was carried out over about five and a half hours. The previous key inspection was carried out on 21.03.08. The requirements made at the last inspection have been met. We spoke to service users, staff and the manager. We sampled records, made observations and had a look around the home. The manager has applied to the Commission to be the Registered Manager and is currently going through the fit person process. She is referred to as the manager in this report. We looked at the Annual Quality Assurance Assessment or AQAA that the manager Care Homes for Adults (18-65 years) Page 6 of 31 completed. This gives information about what the home does well and how they intend to improve. We looked at other information we have received about the home including any concerns, complaints and notifications about incidents and accidents. We listened to what people have told us about the service. What the care home does well: What has improved since the last inspection? What they could do better: The assessment carried out before a person moves in should include information about the persons personal goals and aspirations. Service user plans must be individual and person centred so people get the support they need to lead the lives they want. Staff must have training about person centred Care Homes for Adults (18-65 years) Page 8 of 31 planning so they know how to support this. There should be plans in place to show how staff are going to support people to develop, increase and learn new skills. This will ensure that people grow in confidence and skill and increase their self esteem. The manager must ensure that complaints are listened to and recorded so they may be fully investigated and addressed. The length of shift that staff work and their ability to work sleep in nights should be reviewed to ensure that service users have good support when they need it. The manager should ensure that there are the right policies and procedures in place so service users and staff know about company policies and get the right support and protection. 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 31 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 31 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. There is some information about the home to help people decide about moving in. The assessment must include information about aspirations so the manager can be sure they have the skills, facilities and competencies to give the right support. Evidence: There is some information about the home that the manager is updating so that it is more meaningful to everyone. She hopes to include photographs and pictures so that people have the information they need to make a decision about the home. We found that a person has moved in since the last inspection. We found that this person has a contract detailing their role and responsibilities and the terms and conditions of their stay. It has the fee for living at the home and what the fee includes. We found that another person does not have a contract so they may not know about the terms of their stay and about the fee they pay and what is included etc. The manager should ensure that everyone has a clear up to date contract so people know what they are paying, what is and is not included in the fee and what the terms of Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: residency are. We found that an assessment of a persons needs is carried out before they move in. We found that the assessment is needs lead. This means that it focuses on a person needs and does not include an assessment of the persons personal goals or aspirations for the future. Without all of this information the manager cannot be sure the home can meet the persons needs and goals. Care Homes for Adults (18-65 years) Page 12 of 31 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. People know that their needs and goals will be recorded and supported. Risks are managed so a risk does not stop a person leading a fulfilled life. People have the support they need to make decisions and choices. Evidence: We found that each person has a service user plan. The manager has recognised there are shortfalls with the current service user plans and has plans to address this. She has started to add more detailed information and started to record peoples aspirations for the future. She said she would like to make plans person centred and more individualised to the person. One service user plan was sampled in detail and two other plans looked at briefly. Service user plans should detail the persons needs and goals as well as show what staff support is needed to support the person. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: All plans look the same so are not individual to each person. We found that some personal goals are recorded in some but there are no plans in place to say how staff should support goals, what they should do and by when. Without detailed plans of support people will not achieve their goals and learn new skills. The manager has recognised this shortfall in the care planning system and has developed her own additions to the plans. We found that no one has had a person centred planning meeting but have formal yearly reviews. This means that people have not had the opportunity to get together with people close to them to talk about what support they need to lead the lives they want. The manager has added a sheet that identifies and records peoples goals like getting a job, going to London for the day. There is a record of what staff need to do and the manager will make it time bound so it shows achievement towards personal goals and will show if the support is right or needs to be changed. We found the life history information page in one plan blank. This means that staff may not have a complete picture of the person and any significant life events. We found that where people are at potential risk, assessments have been carried out. This means that the risk has been considered and steps taken to reduce risks to people. Information is recorded on what staff need to do to reduce potential risks to people. The manager has introduced a new risk assessment tool showing the likelihood and potential severity of a risk. This makes things clearer to staff and service users. We found that there is basic information about communication needs recorded in care plans. For example one plan explained how a person communicates with one word, talking. However on speaking to the person it is clear that some more support is needed with communication. The manager has recognised this and written further more detailed guidance for staff about how people prefer to communicate and added this to plans. These plans of support mean that people have better support to make choices and decisions about their lives. We found that not all information is presented in a way that is meaningful to all service users and some information is not available at all. For example people currently only know who is on duty if they ask staff. This means that they are not in control of finding out for themselves. The manager has recognised this and plans to take photographs of staff, which she plans to display with the rota. Care Homes for Adults (18-65 years) Page 14 of 31 Care Homes for Adults (18-65 years) Page 15 of 31 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 have the opportunity to access a range of activities. People have the support they need to keep in touch with family and friends. Food is wholesome and people have choices. More needs to be done to support people to develop and increase their skills. Evidence: We found that there is a range of activities on offer that people have the opportunity to take part in. Some of the activities are group activities provided by the company and held at a local community centre. Evening activities like discos are also offered. Some people access community based activities. For example one person goes out for regular walks locally and one person attends a day centre in Folkestone. Each person has an activity planner covering seven days and evenings. Activity plans are displayed Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: so people know what they are doing from day to day. On the day of the visit one person missed out on their activity due to staff sickness. The manager said she would support the person with the activity the next day instead and the service user agreed. We found that one person would like a job in the future. The manager said she plans to talk to the person about this and give them the support they need to fulfil this ambition. We found that there are no plans in place to increase and develop people skills. For example, with things like cooking, budgeting etc. The manager said she has recognised this and plans to address it by putting plans in place so that people have the opportunity to develop and increase their skills, control and self esteem. We found that relationships are supported and people have opportunities to make friends. People have the support they need keep in touch with family and friends. Families and friends are made to feel welcome when they visit. Families are involved in reviewing service user plans as they are invited to review meetings. We found that service users have support to do the cooking and cleaning. People make their own drinks and get involved in planning and preparing meals. The menu is displayed so people know what they are having and can make a choice. Service users go to the local shops to buy small household and personal items. We found that drinks and fruit are readily available. We found that staff monitor peoples weight so they act quickly if they notice any change. People have support to access the community like local pubs, shops, churches and cafes. Some people are planning their holidays. Peoples hobbies are supported and encouraged. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that their personal and health needs will be supported. Medication practice is safe. Evidence: We found that personal care needs are recorded in service user plans although there is not much detail about how people want to be supported. Without detail people may not get the support they need in the way they prefer. The manager has recognised this and is adding more detail. We found no plans in place to develop or increase peoples skills with personal care. This means that skills may not be developed so people have to continue to rely on staff. The manager has recognised this and plans to improve this to help people increase their skills. We found that health needs are recorded with clear guidance on how to support people to stay healthy. Everyone has a GP and staff make referrals for extra health support when necessary. Everyone has a health checklist and the manager has developed Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: health action plans with people to show what support they need to remain healthy. This is work in progress as some health action plans are not fully completed. The manager has tried to make these as meaningful to service users as possible. We found that medication storage is safe and there are good records of receipt and administration of medication. Although storage is safe it is a difficult to get to, as staff have to navigate around the sleep in bed to get to the cabinet. The manager said she plans to improve storage by giving people their own medication cabinets in their rooms. She said she plans to give people the support they need to take more control of their medication. Having medication stored safely in the individuals room will also mean that taking medication will be more private and dignified. We found that staff have training before they administer medicines. The manager has added more detail to service users plans about medication so staff know how people want to be supported. Care Homes for Adults (18-65 years) Page 19 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service know who to complain to but cannot be sure their complaints will be listened to and addressed. Staff know about safeguarding procedures to keep people safe and protect them from harm and abuse. Evidence: We found that there is a written complaints procedure displayed in the home. This is also produced with text and symbols. The manager agreed that this may not be meaningful to everyone so people who use the service may not know how to use the complaints procedure. We found that a service user has made a complaint that has not been recorded and addressed. This means that there is no record of any investigation or action taken to address the complaint. So the complaint has not been addressed and the issue is ongoing. Staff must have the competencies to recognise when service users are complaining and deal with the issues raised. We found that on 10.01.09 at a service user meeting a person made a complaint and at a service user meeting on 16.02.09 some service users made a complaint. Neither of these complaints had been recorded as complaints. Therefore there is no record of any investigation and any action that has been or is going to be taken to sort things out and improve the service for people. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: There is a safeguarding vulnerable adults and whistle blowing policy and procedure. Staff attend training in safeguarding vulnerable adults. We found that staff are clear about the safeguarding protocols and know what action to take if a disclosure is made or concern reported to them. This means that service users are protected. The staff support people with their money. One plan said my involvement with money is, this is blank and the support I need with money is blank. The manager has written clear information about what support people need to manage their money, however without plans to increase peoples skills and knowledge they will have to continue to rely on staff. Care Homes for Adults (18-65 years) Page 21 of 31 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 home is well maintained and a pleasant safe place to live. Evidence: The home is generally well maintained with adequate furniture and fittings. There are spacious communal areas and each bedroom is single but none has a wash hand basin. There is one bathroom and toilet. People have complained about the uneven driveway at a recent service user meeting. The manager said there are plans to have the driveway repaired. There is access to the back garden so people can get fresh air when they want although the exit to the garden is in the staff office. The garden has been cleared of rubbish as required at the last inspection. They have purchased new fridges and freezers and consulted the environmental health officer about the environment as previously required. People are offered a key to their bedroom but if they cannot manage a key there is no alternative locking devices fitted. This means that people may not have the opportunity to keep their rooms locked and their precious things safe. No one has a Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: key to the front door at present. We found the home is clean and smells fresh. There is a new kitchen, bathroom and boiler and there has been some redecoration of the home. Care Homes for Adults (18-65 years) Page 23 of 31 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 are enough staff to support service users. The length of shift should be reviewed with staff and service users. Outcomes will be improved if staff have in depth training in person centred planning. Evidence: We found that access to mandatory training is good and the induction is adequate. We found that training relating to service users needs is limited for example, training is person centred planning is very limited although all of the staff have had one days training on person centred thinking. This means that staff are not competent in developing person centred plans with individuals to support them achieve their goals and live the lives they want. We found that recruitment checks are carried out before a person starts work at the home. The manager said that the home is fully staffed with some long standing staff who know service users well and some new staff getting to know people. The staff team is relatively small so they call on staff from other company homes to cover any shortfalls. This means that service users get more continuity of care and support. We found that there is usually one staff on duty during the day with the manager and Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: one sleep in staff at night. Extra staff can be called in for activities planned in advance. We found that staff work up to 14 hour long shifts and sleep in nights. Although the manager said that staff prefer to work these hours, service users may not benefit if staff are tired or stressed after such long days. The manager agreed to talk to service users about it and keep the shift length under review. We found that one staff may not be suitable to working sleep in nights because they want to go to bed earlier than service users. The manager agreed to look into this so service users get the support they need at the time they need it. We found that staff have the opportunity to attend regular staff meetings and supervision meetings. This means they have the opportunity to discuss training, service issues and have the support and coaching they need. We found that staff are respectful to service users in that they knock on the front door and wait to be let in to the home and they knock on service users doors before entering. We heard staff talking to service users positively and respectfully. We observed the manager encouraging a person to make their own hot drink and gave the right support to enable them to do this. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in peoples best interests. People know that their health and safety is protected. Evidence: The manager has several years experience in working with people with a learning disability. She has the qualification required by the Minimum Standards but has no formal qualification relating to learning disabilities. The manager spoke about the improvements she plans to make which will improve outcomes for people who use the service. The manager has applied to us to be the registered manager. This means that people will know she is a fit person to manage the home. We found that there are some quality assurance systems in place. The manager completes weekly and monthly returns for head office. The manager said that surveys are sent out to stakeholders by head office but the manager was not aware of any responses or action plan from these surveys. We found that service users meetings are held so people get to air their views. The AQAA gives examples of changes that have Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: been made based on service users views including improvements to the environment and menus. An area manager or other senior manager makes monthly monitoring visits to the home. We found that reports are completed and show that service users and staff are spoken to. The AQAA shows that health and safety checks are carried out. We found that staff attend training related to health and safety including food safety and first aid. We found that fire equipment is checked regularly and fire drills are held so staff and service users can practice evacuating the building. The manager has produced some accessible fire instructions for people so they know what to do in the event of a fire. The manager has sought advice from the local fire officer and as a result new fire doors have been fitted. The AQAA shows that not all of the required policies are in place. For example there is no policy about sexuality and relationships. This means that staff and service users will not have the information they need relating to this subject. Care Homes for Adults (18-65 years) Page 27 of 31 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 31 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 22 22 The manager must ensure 30/04/2009 that all complaints are listened to and recorded and fully investigated. To ensure that peoples complaints are investigated and action taken to address the issues. To ensure that the service improves for people. To ensure that people have confidence in the complaints procedure and know they will be listened to. 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 32 To ensure that service users have the support they need to develop individual person centred plans, staff should have in depth training so they know what PCP is. Care Homes for Adults (18-65 years) Page 29 of 31 2 33 The length of shift that staff work and the suitability of staff working sleep in shifts should be reviewed to ensure that staff are not tired and, or stressed which will affect the support for service users. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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