Inspection on 10/02/09 for The Legard

This inspection was carried out on 10th February 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Legard 09/01/08

The Legard 16/01/07

The Legard 16/03/06

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

Pennine Camphill

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 Legard Wivern Road Holderness Road Kingston upon Hull East Yorkshire HU9 4HU     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: Christina Bettison     Date: 1 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 30 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 30 Information about the care home Name of care home: Address: The Legard Wivern Road Holderness Road Kingston upon Hull East Yorkshire HU9 4HU 01482781039 01482781008 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Milbury Care Services Ltd Name of registered manager (if applicable) Kerry Ann Shepherd Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 8 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 - Code LD Physical disability - Code PD Date of last inspection Brief description of the care home Milbury Care own and manage The Legard. The home is registered to provide care and accommodation for up to 8 adults between the ages of 18-65 who have a learning disability and may also have physical disabilities. The home is located to the east of Hull city centre and is purpose built. The main home has eight single bedrooms, four upstairs and four downstairs. Bedrooms are paired together, each pair separated by a fully equipped disabled Care Homes for Adults (18-65 years) Page 4 of 30 care home 8 Over 65 0 0 8 8 Brief description of the care home bathroom, each bedroom having individual access from either side. The upstairs bedrooms are set in two apartment-style living arrangements, each with a lounge and kitchen to promote independence living. There is an office, large hallway, kitchen/dining room, laundry, sensory room and shower room downstairs. Upstairs is an activity room and staff sleep-in room. There is wheelchair access throughout and a platform lift providing access to the upstairs accommodation. The home has a large garden to the side and rear. There is a car park area to the side with additional street parking. At the time of inspection there were 8 people living at the home. Information about the home is available in the home and the companys offices. 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: The quality rating for this service is 2 stars. This means that the people who use the service experiences good quality outcomes. This visit was unannounced and took place over 6 and a half hours on 10th February 2009. This home was last inspected on the 9th January 2008. During the visit we observed how staff interacted with the people who live in the home to find out what it was like for them living at this service. Care Homes for Adults (18-65 years) Page 6 of 30 We spoke to the managers and staff members on duty on the day of the visit, we also met the people who live there. We received a survey back from a relative who did not make any negative comments about the home and we spoke to a relative who was visiting on the day of our visit. We received 3 surveys back from health professionals, 3 from people who use the service and 4 from staff, none of which contained any negative feedback. We checked documents that related to peoples care and safety. These included care plans, daily records, risk assessments, staff supervision and training records. We looked at the environment and checked maintenance records to make sure the house was safe and well maintained for the people who live there. Before the site visit we also looked at a range of other information we had received about the service since the previous inspection. This was a key inspection and was carried out by Regulation Inspector Tina Bettison, we would like to thank the people who live at the service and the staff for their co operation during our visit. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: There needs to be more prompt attention to repairs and redecoration. People need to be properly assessed and specialist seating needs to be provided for Care Homes for Adults (18-65 years) Page 8 of 30 individuals based on professional advice and recommendations. Staff commencing employment without a full CRB clearance must be supervised to ensure that people are kept safe from the risk of harm. Risk assessments need to be more meaningful and not just a paper exercise for every element of the care plans. Areas that pose a risk need to be properly assessed and strategies put in place to minimise risks. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live in the home have a range of assessments carried out by professional people this means that peoples individual needs are identified and are able to be met. Evidence: There has been one new admission to the home since the previous visit. The care file for this person and one other person were examined in the course of the visit. Both contained an up to date assessment completed by the placing local authority and for the new person there was also a very detailed assessment completed by the manager of the home. In addition to this a number of professionals have been or continue to be involved in providing assessments of particular areas of need, i.e eating and drinking, mobility etc. The manager told us that other areas of need for the new person were still being assessed to ensure that their needs are accurately identified and therefore met. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: This ongoing assessment work needs to be identified in the care plan so that it is clearly evidenced and all staff are aware. At the previous visit it was identified that staff were not being provided in sufficient numbers to meet all of peoples needs and did not reflect what was written in peoples contracts and statement of terms and conditions, this has now been addressed and staffing numbers have increased. (see staffing section of this report) 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. Peoples needs are met by a stable, caring and competent staff team that know people well. Care plans and guidelines are in place to guide any new staff in how to meet peoples complex needs and keep them safe however the poor quality of the risk assessments may compromise this and further development of these will enhance the service provided. Evidence: Two care files were examined as part of the visit. Care files and the format have been radically improved since the previous visit. The format ensures that all areas of peoples needs are identified. We were told that although they are now completed for everyone in the home, there is still some fine tuning to ensure that no areas of need are missed. Both files included an initial overview of the person, their history, needs, likes and Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: dislikes. Peoples individual plans were very detailed to ensure that staff are aware of all of their needs and are able to provide appropriate and consistent care to meet their needs. It was clear that peoples needs were being met and there were good diary records to indicate what care had been delivered on a daily basis. One of the people whose care file was examined has specific needs in relation to communication and a communication passport was seen on file that detailed how they prefer to communicate and what their body language and gestures mean. Where people display behaviours that can be difficult to manage, behaviour management strategies and techniques to be used where detailed in a behaviour support plan. There were risk assessments for every care plan need identified and on some occasions these were of poor quality and duplicated information in the care plan. This approach means that risk assessments become meaningless and are not truly identifying areas that pose a risk to people and do not detail how these risks will be minimised. This must be addressed. 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. A range of activities provided within the home and community means that people who live in the home have the opportunity to participate in stimulating and motivating activities that meet their needs. Evidence: The managers and staff have worked to improve standards in this area. There was evidence in care files that peoples needs/likes/dislikes in respect of activities and lifestyle choices had been identified and recorded. Religion had been recorded and whether the person is practicing or not. Staffing numbers in the home have improved and this has meant that people are supported to get out of the home and participate in activities of their choosing more regularly. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: A visiting relative that was in the home on the day of the visit told us that her brother goes out a lot and he has a better social life than me We were told that people go the local community centre for movement to music, go swimming, go for walks, go shopping, have trips to the theatre and cinema and in the home undertake household chores, enjoy TV and music, hand and foot massages and on the day of the visit a group were taking part in a karaoke session which everyone appearred to be enjoying and participating in their own way. One or two people who did not wish to participate were in their rooms enjoying their own hobbies of play station and books. People had been on holiday last year to Blackpool, Haven caravan site in Skegness and primrose valley. Menus contained a variety of meals that included fresh fruit and vegetables and took into account people likes and dislikes and special diets. A visiting relative told us that meals are healthy and that at Christmas time staff made it a very special time with a lovely Christmas dinner, everyone sat around the table with Christmas crackers and hats on. The home has a food safety act rating of B which is good. People are supported to receive visits from their relatives and contact is welcomed, the visiting relative told us that she is always made to feel welcome, offered drinks and on occasions asked if she wished to stay for a meal. 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. Peoples health needs are met by the provision of detailed health plans and good recording of outcomes and medication is well managed. Evidence: Two care files were examined as part of the inspection process and this evidenced that peoples healthcare needs were being met. Health plans were incorporated into the overall care plans and had been prepared by staff in the home. Both health plans were very detailed and there was very good evidence of visits to and from GP, dentist, optician, chiropody, consultants, community or district nursing, epilepsy nurse etc. It was evident that for the new person recently admitted that a range of referrals had been made for updated assessments i.e dietician, OT, physio and speech and language therapist. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: There was good evidence of monitoring for food/fluid intake, weight, seizure activity and for one person who uses Oxygen throughout the night there were records of nighttime monitoring. There are currently no people self medicating and there was no one prescribed controlled drugs at the time of the visit. There are policies and procedures in place for the administration of medication and PRN protocols were in place for the administration of medication on an as and when basis. Medication was seen to be well managed. 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 staff understand their responsibilities to ensure the protection of vulnerable adults and the provision of detailed plans, behaviour management plans, and attention to health needs ensures that on the whole people are protected from the risk of harm. Evidence: The home has a complaints procedure and a log of complaints and action taken. There have been no complaints either to the home or CSCI since the previous inspection. The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint and management of money and financial affairs. Most staff have completed protection of vulnerable adults training and understand their responsibilities within this and the provision of detailed plans, behaviour management plans, and attention to health needs ensures that on the whole people are protected from the risk of harm. There has been one safeguarding adult referral made to the LA, this was made by the manager of the service and does not relate to any action of staff or other service users Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: at the home. This is currently being investigated by the LA. 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 environment provides people with a large, spacious homely and comfortable surroundings in which to live with all of the equipment provided to ensure their physical needs are met however the decor is staring to look worn and needs attention. Evidence: The previous inspection visit rated this area as excellent. The environment continues to provide people with large, spacious homely and comfortable surroundings in which to live and all of the equipment required to ensure that peoples physical needs can be met and their independence promoted is. All of the people have a single room with en suite facilities. All equipment needed to meet peoples physical needs was provided including specialist baths, ceiling track hoists, mobile hoists, toilet, bath and shower aids, wheelchairs and one person had possum system to enable them to control their lights, curtains and entertainment systems in their room. There are two separate apartments (upstairs) each with two bedrooms, a kitchen and Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: lounge to share. These are aimed at promoting more independent living. Downstairs there are four more bedrooms, a communal lounge, kitchen/dining room, activity room, sensory room and laundry. Furnishings were of good quality and the home was clean and tidy. As part of the visit all of the maintenance certificates were checked and all were up to date. However the home is starting to look worn and tatty in places, some carpets are stained, plasterwork and paintwork is damaged due to constant knocks from wheelchairs. We were told that access to the handyman is more limited now as he has to cover a bigger patch and more homes and the manager has to make a request for painting etc. We were also told that staff had come in to the home in their own time to decorate service users bedrooms, this is unacceptable and the organisation must provide a more responsive method for ensuring to ongoing upkeep of the home. This section has been rated as good this time due to the inadequate provison of decoration. 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. Peoples needs are met by stable, caring and well trained staff that are provided in sufficient numbers to meet everyones needs however the lack of CRB clearance does not ensure that people are protected from the risk of harm. Evidence: The previous inspection raised concerns about the numbers of staffing in the home and the fact that there were not sufficient numbers of staff to meet everyones needs. A staffing calculation was completed based on 8 people living in the home all with high support needs and this indicated that the home should have a minimum of 636.85 hours per week. We were told that the staffing hours have now increased to 640 hours per week and that the home are now fully staffed with permanent workers. Staffing consists of 1 x registered manager 1 x deputy manager 2 x senior support workers (both new since the previous inspection) 11 x support workers (4 of which are new since the Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: previous inspection) 4 x night support workers 2 x regular bank workers The personnel files were examined for the new staff that have commenced since the previous inspection and all but 1 were found to have all the necessary clearances in place. For one person who had commenced in August 2008 it was concerning that their CRB clearance had still not been obtained and they were working without supervision. This was discussed with the area manager who confirmed that after further enquiries it appeared that the member of staff does not have a current CRB clearance and has not been working under any form of supervision. This does not protect people from the risk of harm and must be addressed. We were told that the increase of staff to 5 on every day shift has made a huge difference to being able to support people to go out on activities and meeting the needs of people. There are 2 staff that work waking nights. Training was seen to be well managed and staff were on the whole up to date with all training, additional training provided this year included mental capacity act, additional POVA, abdominal massage, postural management, eating and swallowing, communication and equality and diversity. One member of staff is a Moving and handling trainer and out of 18 staff 7 have achieved NVQ level 2 or above and 5 are registered and working toward it. Staff supervision is provided regularly and all staff who needed one have received an annual appraisal. 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. The home is well managed and peoples complicated needs are met by a stable, competent and caring staff team. The people that live in the home are happy and their independence is promoted. Evidence: The Legard is part of the Milbury/Voyage care services which is a national provider of care and support services for people with a learning disability. It is part of Paragon healthcare group which is UK wide organisation. Since the previous inspection the manager has returned to manage this home on a full time basis. The manager is very competent and skilled in her job and provides good guidance and leadership to the staff team. The manager has her NVQ level 4 and the registered manager award, she is very knowledgeable about all of the people that live in the home and very supportive of the Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: staff. Requirements made at the previous inspection have all been met and advice and guidance was given throughout the visit on how to improve the service up to an excellent level. The manager submitted an AQAA which was of a good standard and she said she keeps this updated throughout the year. As part of the visit we examined the maintenance and servicing records which were all up to date. We were told that Milbury/Voyage have a QA system which includes regular audits and monitoring of the service culminating in an annual service review. The area manager undertakes regulation 26 visits on monthly basis. None of the QA documentation was examined by the inspector at this visit. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 34 18 The registered person must ensure that staff have a satisfactory CRB clearance on file prior to commencing employment. 10/01/2008 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 9 13 The organisation must 30/04/2009 ensure that there is a difference between a care plan need and an area of risk that needs assessing, risk assessments must detail how risk are going to be minimised and identify what if any risks remain this will ensure that risk assessments are meaningful and that staff take note of to keep people safe form the risk of harm. 2 34 18 The organisation must 13/02/2009 ensure that staff have the required clearances before commencing work and if starting on a POVA first they must be appropriately supervised this will mean that people who use the service are protected from the risk of harm. Care Homes for Adults (18-65 years) Page 28 of 30 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 2 The organisation should ensure that ongoing assessments being undertaken by staff or other professionals are recorded in the care plan to evidence ongoing work and so that all staff are aware and able to respond consistently. The organisation should ensure that there are adequate resources available in a timely manner to ensure that the home is kept well decorated at all times. 2 24 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 © (2009) Commission for Social Care Inspection (CSCI). 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