Care Home: 110 Oakleigh Road North

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What the care home does well The service is very good at providing warm, friendly and supportive care to it`s four residents. Staff are highly motivated and enjoy working at the home. The service is also well managed and organised. There is a thoroughness to each area of activity with care arrangements well thought out and other aspects of the home such as health and safety and maintaining a safe environment equally well attended to. Care plans are good with lots of detail about needs and plans to meet needs. The work has been broken down into specific goals for each resident. The review of work carried out is frequent and there is evidence that staff have been able to influence work for the benefit of residents. Residents are provided with lots of opportunities to lead active lives. Support is provided to have varied daily programmes as well as take part in leisure activities including holidays. Support is also provided to keep in contact with friends and relatives as well as attend chosen activities such as church. Staff support is good. Staff are happy and feel supported. Training is varied and the recruitment process is thorough. The management systems are carefully planned and carried out with the quality assurance audits being a good example of a system that reviews itself carefully and makes improvements quickly when needed. What has improved since the last inspection? The statement of purpose and service users` guide have been updated with the service users` guide now more accessible for residents as it has pictures and symbols. Care plans are clear and provide evidence of residents` consent and agreement to the care provided. Training records are now clearer and more detailed and required fire and legionella checks have been carried out. The service is good at making sure that recommendations made are complied with. What the care home could do better: This inspection has identified that the service provided is excellent. Nonetheless, a small number of areas have been identified where improvements could be made. The areas include the following. Additional drivers amongst the staff team are needed so that residents can use the car when needed. Care plans could be developed using pictures, photographs and symbols. The quality assurance surveys should be carried out annually with a wider range of people involved. New staff need to be included in the training records and provided with safeguarding adults training. The staff recruitment records need to cover any gaps or discrepancies in work histories and the complaint records need to link with other information held elsewhere. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 110 Oakleigh Road North 110 Oakleigh Road North Whetstone London N20 9EZ     The quality rating for this care home is:   three star excellent 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: Duncan Paterson     Date: 1 7 0 7 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 28 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 28 Information about the care home Name of care home: Address: 110 Oakleigh Road North 110 Oakleigh Road North Whetstone London N20 9EZ 02084451310 02088839330 willowcarehomes@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Willow Care Homes Ltd care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 4 110 Oakleigh Road North is a registered care home providing personal care for four adults aged 18 - 65 who have learning disabilities. It is owned and run by Willow Care Homes Ltd, an independent sector provider offering a range of accommodation for people with learning disabilities in the London Borough of Barnet. The home has four single bedrooms which include en suite bathrooms. An additional bathroom for communal use is also available on the ground floor. The downstairs bedroom is accessible for people who have more specific needs or limited mobility. There are also a lounge, kitchen, dining room and laundry area within the home, and an office on the ground floor. The home is centrally located within easy reach of the main town and shopping area of Whetstone, with good transport links into central London and the surrounding areas. Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home The home aims to provide a service for people with a learning disability who may have some additional health or behaviour related needs and may have a relatively high level of dependence on the support provided by staff. Care Homes for Adults (18-65 years) Page 5 of 28 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection took place on 17 July 2009. The inspection involved talking with the manager, interviewing staff and talking with residents. Observations of care practice also took place as well as a tour of the premises and an inspection of a sample of care plans, staff files, policies and procedures and other records kept at the home. The Annual Quality Assurance Assessment (AQAA) was returned to us before the inspection and this was taken into consideration. The new manager assisted with the inspection and the current registered manager was also present for part of the inspection. The current manager now has a wider management role in the organisation but is present to assist and guide the new manager. The new manager is to apply for registration in the near future. Care Homes for Adults (18-65 years) Page 6 of 28 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 Care Homes for Adults (18-65 years) Page 8 of 28 7535. Care Homes for Adults (18-65 years) Page 9 of 28 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 28 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. There is a range of information available for people using the service now in more accessible formats. People using the service receive care from a supportive staff team who have worked well to plan care based on peoples individual needs. Evidence: Since the last inspection of 27 July 2007 the statement of purpose and service users guide have been re-written. The statement of purpose provides a clear, detailed description of the home and the service provided. The service users guide now contains pictures and symbols to make the document more attractive and meaningful for residents. None of the four residents are new. All moved to the home when the service opened in 2006. Therefore, there were no new assessments available for inspection. However, care plans were inspected for two of the residents. These provided detailed assessments of need as well as plans for meeting needs and reviews. There are clear plans in place for staff to work with to meet peoples needs. Staff were able to describe Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: the work they were doing with each resident. Staff were observed to work warmly with residents and communicate with them appropriately. Residents either said that staff worked with them how they wished or staff were observed to be working with residents on specific areas. For example, working with one resident to develop eating and drinking skills. Contracts, signed by residents, were seen on the individual files. The AQAA returned to us set out ways in which the service was addressing equality and diversity. These included the provision of culturally appropriate food, using a person centred planning approach and assisting residents to attend religious services. Residents either confirmed this was happening or evidence was seen such as menu planning and activity records. Care Homes for Adults (18-65 years) Page 12 of 28 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. The care planning arrangements are good with detailed care plans in place as well as clear objectives for staff to follow to address residents needs. The service is good at organising care arrangements which mean that staff are clear how they can assist residents. Evidence: Two care plans were inspected in detail and discussed with the manager and staff. Each care plan is set out to a standard format which clearly outlines the care plan objectives for each person. To these are added a number of other care planning initiatives including skills development forms, a record of skill development progress and achievement and records of client activity outcomes. Monthly reviews and monthly client reviews take place to assess progress and development. These link to the regular six monthly review cycle and annual local authority review. There was evidence that issues had been followed through these stages such as the need for one resident to be referred to a specialist health care professional. Staff at the home had followed Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: this through. A number of the initiatives have been introduced following a quality assurance audit. Together they provide a very good means to be clear about how staff are working with residents. They allow a focus on specific skills which they are planning to address. Examples seen included assisting residents to do practical tasks such as laundry as well as communication. Each care plan objective and other aspects such as monthly reviews have been agreed and signed by residents. Staff confirmed that the discussions with residents took place and staff demonstrated a good knowledge and understanding of residents and their needs. From discussion with residents and observation it was less clear how agreements for care plan objectives were reached although residents said that they had a lot of contact with their keyworkers. The care plans are not presented using pictures, symbols and photographs and using such may assist with the agreements as well as develop person centred planning. Residents participate in many ways at the home. During the inspection residents were observed to interact freely and informally with staff. One resident discussed money, trips out and a whole range of matters with staff. Another resident was involved in preparing the evening meal. In addition, there were records available of residents meetings and the manager advised that one of the residents had been involved in an interview panel for new staff. In similar fashion to the care plans each resident has detailed risk assessments which cover a range of assessed risks. These had all been reviewed regularly and again staff had a good understanding of risk and of residents needs. Records are held confidentially in the office and there is a relevant policy that covers these arrangements. Care Homes for Adults (18-65 years) Page 14 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are very good arrangements to encourage and support residents taking an active part in community life. Equally, there are good arrangements for residents leisure activities and for keeping in touch with friends and relatives. Food arrangements are well considered. Evidence: Each resident has an activity programme and daily records are kept of activities carried out. Residents are generally out of the home during weekdays attending day centres or a variety of other settings including a local arts centre. Each resident has a one-to-one session with their keyworker at least once a week. For example, on the day of the inspection one resident went out with his keyworker for a meal. The manager and staff have been able to organise work patterns so that residents are Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: assisted and encouraged to take up opportunities in the community. There is a car which belongs to the home and paid for by residents through their Disability Living Allowance. Unfortunately, at the time of the inspection there were only two drivers amongst the staff team so there could be times when there is no staff member to drive. Although staff from one of the organisations other care homes could assist if needed there is a need to recruit staff who can drive. Residents spoke about a recent holiday as well as other leisure activities such as trips to the cinema. Two residents attend a local church on Sundays. None of the residents work although college courses have been attended in the past. Care plans provided evidence that residents were enabled to maintain contact with friends and relatives. For example, reference to relatives were included in care plans and relatives had attended reviews. One resident said that a close friend was due to visit for a weekend in the near future. Staff were observed to work kindly and sensitively with residents, respecting their needs and wishes and encouraging them to participate in life at the home. Staff assisted residents to carry out day-to-day tasks such as laundry work. Menus were seen as well as records of residents meetings held to decide which meals to eat. The simple devise is used of supermarket colour meal cards being shown to residents to help choice. The cards are then used as a recipe for meals and are displayed in the dining area. The evening meal of summery salmon was prepared and served on the day of the inspection. This was a healthy choice and it looked appetising. The menus provided evidence that a range of meals are provided. The kitchen is modern, clean and well ordered. It provides a pleasant setting for residents as well as well equipped facilities to prepare food. Barnet Council carried out a food safety inspection in 2007 and awarded five stars. This is the top rating available. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents personal and healthcare needs have been responded to well by staff. Specific details of care and health needs and guidance for staff are available and there are clear records of referrals to health care professionals. Medication arrangements are also clear and well organised. Evidence: As already described, the care plans are well organised and provide well thought out plans to meet residents needs. They are detailed, drawn up with residents and reflect how residents wish to be cared for. Staff are highly motivated and wish to provide a good service for residents. All staff spoken with said that the best thing working at this home was working with the residents. In addition, the care plans set out the arrangements for additional support such as from health care professionals. Staff provide a keyworker service for residents and were able to describe their duties. Care plans contained a section on health notes which include details of any accidents. In addition, records of medical appointments were kept on care plans as well as records of nutrition and monthly records of residents weights. Where residents may Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: have specific needs, such as swallowing issues, details were also provided as well as guidance for staff. The Boots medication system is used. The medication administration records and storage arrangements were inspected. Residents have signed their consent for medication and these are kept on care plans along with medication profiles. Details of any resident allergies are also kept. The medication records were complete with no gaps and were well kept. There are additional daily records available of the temperature of the room in which the medication is stored. Care Homes for Adults (18-65 years) Page 18 of 28 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 complaint and safeguarding arrangements are good. Staff are knowledgeable in these areas and have received training. Some attention to complaint recordings will improve the arrangements further. Evidence: There has been one complaint since the last inspection. The complaint was also a safeguarding matter that had been referred appropriately to the local authority. However, the complaint records did not signpost or link up with the other homes records so an incomplete picture was formed. Complaint records should provide sufficient details or should link to other records so that evidence is provided that the matters have been fully investigated. A recommendation is given about this. The safeguarding arrangements are good. There is a policy and procedure that provides clear guidance to staff. The majority of staff have received safeguarding training although new staff need this training. Staff spoken with demonstrated knowledge about safeguarding matters. As above, there had been a safeguarding incident in this home earlier in 2009 and it was responded to properly. In addition, the manager has attended a local authority training course on the new Deprivation of Liberty Safeguards and is in a position to cascade this training to staff. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having modern, well equipped facilities. The home is clean and well kept and residents can enjoy a good quality of physical standards at this home. Evidence: The service is provided in a modern, large house. The home is clean, pleasantly decorated and with good quality facilities and furnishings provided. There is a modern kitchen, a large garden and a comfortable lounge complete with plenty of space and three sofas. The home was neat and tidy and fresh smelling. Two residents bedrooms were visited by invitation. Both were furnished with modern furnishings and en suite facilities. Each resident had personalised their bedrooms with their own belongings and created a homely environment for themselves. The laundry is housed in a separate laundry room on the ground floor and is well equipped. There are no major adaptations for people with disabilities as residents are able to use the facilities although there is one bedroom on the ground floor. There is a separate toilet and bathroom on the ground floor as well. Records were seen of regular checks of the bath temperatures. Care Homes for Adults (18-65 years) Page 20 of 28 Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive care from motivated, well trained and supported staff who enjoy their work. Recruitment is thorough and there are good systems for staff support and supervision. Evidence: The staffing rota was inspected. On the day of the inspection there were two staff working in the morning shift and two in the afternoon. The manager was one of the morning staff. The staffing levels vary as the manager works as a care worker for three days a week. She carries out management tasks for the other two days. Therefore, when she is conducting her management work there are two additional staff on duty. There are four residents so for the most part this level of staffing works well although there could be a limitation for activities in the evenings and weekends with only two staff available with one staff member always needed to prepare the evening meal. Care staff on duty were interviewed. They all provided positive comments about working at the home and presented as a happy, motivated and caring staff team. They reported being well supported by the manager and that the team worked well Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: together. One staff member said, I love it. I like the residents. Everything is above board. The organisation is good. If I have a problem theyll address it straightaway. Four staff files for newer staff were inspected to assess the recruitment process. Overall, a good standard has been achieved. The required checks had been carried out and each person had a Criminal Records Bureau (CRB) check. However, one staff file seen contained a reference from an employer which was not detailed on the work history. This was raised with the manager who agreed to look into it. A recommendation is given about this. Staff training records were also inspected. Evidence was provided that staff had been provided with a range of training. Staff confirmed that they had received training. The AQAA reported that 50 of the staff have completed NVQ training. However, the training records needed to be updated to include new staff and at least one member of staff needs to attend the four day First Aid at Work course. Staff supervision records were seen and staff confirmed that they received supervision on a regular basis. Care Homes for Adults (18-65 years) Page 23 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are very good management systems in place. There is a thoroughness to the systems and the new manager has been supported and assisted in her new role. The quality assurance system is varied and detailed and has enabled the service to quickly respond with improvements which benefit residents. Evidence: The manager has been preparing for her application to us for registration. The application is now to be submitted. The current registered manager was present for part of the inspection and was able to provide more context about how the wider organisation operates. He has been able to support and guide the new manager in her role. Although not yet registered the manager demonstrated a good understanding of her role and had been able to lead and manage staff in an appropriate way. One of the ways in which the organisation works is to employ an external assessor who carries out a quality assurance monitoring audit of the service at regular intervals. There have Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: been three such audits since the home opened in 2006. The most recent audit was carried out in November 2008. The report of this audit was seen. The majority of the findings endorsed the way the home was being run and managed although a number of recommendations were made. The manager had taken action to address the recommendations and had held a team meeting at which a Team Action Plan was generated. This was also seen. Many of the responses by the manager and staff team involved improvements to the acre planning system already mentioned in this report. The quality assurance audit has meant that the service is closely monitored and it has been able to quickly make improvements. The other quality assurance initiatives carried out were viewed. Surveys are carried out although it was identified that these had not been done annually as is usually the case. A recommendation is given about this so that surveys are carried out regularly and include stakeholders such as local authority staff. A sample of policies and procedures as well as maintenance checks and health and safety records were inspected. These were all up-to-date and available for inspection. Evidence was provided that policies and procedures are clear and accessible and reviewed regularly and that the homes equipment such as fire systems and electrical safety are checked regularly. As with other paperwork relating to the running of the service these records were thoroughly kept. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 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 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 6 Consider adding pictures, symbols and photographs to residents care plans to assist with the development of person centred planning. Additional drivers amongst the staff team should be provided. Complaint records should link with records held elsewhere so that a complete picture of the complaint investigation is available. New staff should be provided with safeguarding adults training. Recruitment records should clarify any gaps or discrepancies in applicants work histories. At least one person should complete the 4 day First Aid at Work course. The training records should be updated to include new staff. Surveys of residents, relatives and other stakeholders such as local authority purchasers of the service should be carried out annually. 2 3 13 22 4 5 6 7 8 23 34 35 35 39 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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