Care Home: 121 Watley`s End

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What the care home does well People are cared for by staff who have a good understanding of their role and responsibilities. People living at the home are supported in being part of the local community. The home provides a supportive environment to help people make choices and maintain their independence. Peoples` communication needs and their wishes are understood by staff. Staff continue to seek support from other healthcare professionals to help review and improve care practice. Comments received from health care professionals included "The physical care given (by staff) is of a high standard" and " I am impressed with the professionalism and dedication of staff." What has improved since the last inspection? The administration records for medication that must be given `as required`, include instruction for when the medication must be given. What the care home could do better: Both care plans and risk assessments must be updated with current information so that peoples` needs are met and they are supported safely. People would benefit from care plans being developed in an accessible way to involve them in understanding better how they are being cared for. People who are unwell would benefit from staff being trained in palliative care practice. Staff must be updated with training in key areas such as understanding and recognising abuse, manual handling and first aid. The home would benefit from new flooring in the hallways. Key inspection report Care homes for adults (18-65 years) Name: Address: 121 Watley`s End 121 Watley`s End Road Winterbourne Sth Gloucestershire BS36 1QG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah Webb     Date: 0 7 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 27 Information about the care home Name of care home: Address: 121 Watley`s End 121 Watley`s End Road Winterbourne Sth Gloucestershire BS36 1QG 01454250232 01454250994 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Name of registered manager (if applicable) Type of registration: Number of places registered: care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Manager must be a RN on part 5 or 14 of the NMC register May accommodate up to 14 persons aged 18 to 65 years and over with learning disability who may also have physical disability and who require nursing care Staffing Notice dated 20/07/2001 applies Date of last inspection Brief description of the care home Aspects and Milestones Trust operate 121 Watleys End Road, which is registered to provide nursing care to 14 adults with a learning disability and a physical disability. The property is located in a quiet residential area, close to local shops and amenities. There are 14 single bedrooms of various sizes, all of which have sinks. There are parking spaces and grounds to the side and rear of the house. The fees that are charged for staying at the Home are #1500.14, a week. There are extra charges for Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 14 14 14 14 Brief description of the care home chiropodist, hairdresser and the shared use and petrol costs of the minibus. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection carried out over one day. Pre inspection planning involved reviewing the report from the last Key Inspection completed in May 2007 and the Annual Service Review completed in May 2008. We also looked at the service history that details all other contact we have had with, or about the home. We looked at the homes Annual Quality Assurance Assessment (AQQA). This is a self assessment, which focuses on how well outcomes are being met for the people living at 121 Watleys End Road. We also looked at surveys we received from people living at the home, staff and both health and social care professionals. We spoke with the manager, staff and met two people living at the home. We viewed all communal areas of the home and some bedrooms used by people living there. We gathered other information during this visit by looking at a number of records such as individuals care plans, risk assessments, daily records, incident and accident forms, Care Homes for Adults (18-65 years) Page 6 of 27 complaints records, medication administration, staffing records and some health and safety procedures. Care Homes for Adults (18-65 years) Page 7 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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. Peoples needs are assessed before they move to the home to help ensure they can be met. Evidence: There have been 3 new people admitted to the home since the last inspection in May 2007. The home follows the organisational admissions policy and procedures when there are vacancies at the home. There is currently one vacancy and we were shown a brochure that is given to people and their representatives when making enquiries. This included photographs with some written information about the home. All the people living at the home are funded by the local authority and had their needs assessed before moving to the home. We reviewed three new peoples assessments. These showed in detail peoples individual care needs, and included activities of daily living such as communication, eating, drinking, personal care and mobility. Their care had been assessed six monthly showing monitoring systems in place to record any changes to their care. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans show how the needs of the people living at the home should be met. Not all care plans had been upated with current practice. The home is aware people would benefit from pictorial information to help them understand how they are cared for. People living at the home are supported to make decisions in their daily life. Although people living at the home are being supported safely to take risks in their daily lives, not all written risk assessments had been updated with changes to the way some people were being supported. Evidence: We saw 3 peoples care plans. Each person had a social services care plan and a care plan developed by the home. Included in the comprehensive information were personal profiles, lifestyle plans, and how people should be supported with their emotional, healthcare and social needs. Although care plans were seen to have been reviewed regularly, one persons care plan needed to be updated with changes to their Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: care. Two surveys received from three healthcare professionals told us peoples social and healthcare needs are properly monitored, reviewed and met by the home always. A third survey told us usually. One person had an Essential Lifestyle Plan. This showed a person centred approach towards their care planning and included how people were supported to keep in touch with their families, and what was important to them. The AQAA identified that people living at the home would benefit from care plans being developed further in a more person centred format to try and help people understand their care better. The people living at the home have complex needs and are supported by a staff team who have a good understanding and knowledge of their communication. Care plans included information for staff in how to understand peoples individual communication. An assessment tool helped staff to know when people were distressed and how to support them. Examples of this were their facial appearance, and vocal signs to help staff know when people were distressed. Daily records of peoples ongoing activities confirmed how people were being cared for. Staff spoken with told us how they tried to involve people in decision making and making choices. Daily routines and activities, choices in food and drink were key areas for people to express themselves. Two surveys received from people living at the home told us they sometimes make decisions about what they want to do during the day. One surveys told us they can do what they want to during the day, evening and weekend while another agreed except for the weekends. From speaking to staff it was evident people were being supported safely in taking risks to help enable them to live as independently as possible. However not all written risk assessments had been updated with current information and changes to their care. It was unclear how an individual was being supported with using a wheelchair. Another person did not have an Epilepsy plan or risk assessment relating to their epilepsy to show how they should be supported. We saw other manual handling assessments that showed how people were being supported safely, the risk factors taken into consideration and the apropriate individual equipment needed. Care Homes for Adults (18-65 years) Page 12 of 27 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 living at the home are supported in taking part in appropriate activities and in being part of the community. People living at the home benefit from a varied and well balanced diet. Evidence: People living at the home are offered individual activities. We saw some people going to their day services, while some others had attended college courses. Daily activities had been recorded in diaries with individual records of hours of support. We saw one persons recorded activities when they had received aromatherapy, snoezlen sessions and hydrotherapy. During May they had been to pubs, the lakes at Chew Valley, the cinema, Bristol Zoo and bowling. Other peoples records showed they had been involved in trips to various locations both locally and further away. These included visits to garden centres, shopping, eating out and trips to Wales and on boat Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: trips. One person was being supported to go on holiday to Blackpool in September. People had been visited by their families, with some families involved in attending parties and holidays. It was evident staff had good working relationships with families. We met the cook who showed us the menus. We saw a varied choice of nutritional meal options were available for people. Peoples preferences had been included in the menus and it was evident peoples individual needs and choices were being taken into consideration. Care Homes for Adults (18-65 years) Page 14 of 27 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 living at the home are supported with their healthcare needs in the way they want. People would benefit from staff trained in the practice of palliative care. People living at the home are supported safely with the administration of their medication. Evidence: A personal care policy identified peoples preferences to how they wanted to be supported. Records had been kept of peoples general well being and these also showed peoples individual daily routines. Staff spoken with had a good understanding of peoples needs and their preferences. Two surveys received from three healthcare specialists told us peoples privacy and dignity is always respected while one said usually. An individuals healthcare record showed visits by dieticians who had assessed their specific healthcare regime. A record of medication showed how staff should be supporting them with this regime. Health Action Plans seen had checklists helping to monitor when people needed medical checks. Another Health Action Plan included advice and instruction for staff in how to support an individual with their medication. A Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: best interests report was seen for two individuals showing how their wishes and feelings were recorded and those views of people involved in their care. Correspondence was seen from General Practitioners(GP), hospitals, consultants and other healthcare specialists. We found that there are more people living at the home with complex healthcare needs since the last inspection. The staff team have had to support some people who had been very unwell. Surveys received from healthcare specialists confirmed staff ask for advice and act on it to meet peoples social and healthcare needs and improve their well being. One survey also told us that as a specialist they were having to give quite complex communication to staff due to peoples changing and more complex needs. Those people who are unwell would benefit from being supported by staff who are trained in the practice of palliative care. We looked at how peoples medication is adminstered and the recording systems in place. The nursing staff administer all medication. We saw photographs of each person and their medication recorded with the side effects. Risk assessments were seen for medication procedures such as PEG feeding. Medication charts had been signed when medication had been administered. A medication errors form was completed if medication had not been administered and the reasons why. A requirement had been met for written guidelines in place to advise staff when to give prescribed medication that is give as required. Medication is checked by the night staff to ensure it is in date and that out of date and unused medication is disposed of appropriately. Care Homes for Adults (18-65 years) Page 16 of 27 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. People living at the home benefit from a staff team who have a good understanding of individuals communication to help them express their complaints. People are protected from abuse but would benefit from all staff given refresher training. Evidence: Staff advocate for people living at the home, and as recorded previously, staff have a good understanding of how to communicate with people and knew when they were distressed or unhappy. We saw the complaints that had been recorded since the last inspection. There were two complaints and it was evident from the action taken by the home that complaints are taken seriously. Both complaints had been reported to adult protection with appropriate action taken. The home follows the organisational policy and procedure for the protection of vulnerable adults. Staff spoken with had a good understanding of how to recognise abuse. They were able to confirm they would report an abusive situation seen or one reported to them. We looked at staff training records that showed that although staff had received training in the protection of vulnerable adults, not all staff had received training updates in this area. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a clean, safe and comfortable home that is suitable for its purpose. Necessary adaptations are in place to help people in their daily lives and to meet their needs. Evidence: 121 Watleys End Road is close to local shops with people able to access local amenities. The home is a purpose built bungalow in a quiet residential area. The entrance of the building is accessible for people who use wheelchairs and there is similar access to all areas. People living at the home are supported with their physical needs with appropriate equipment. There were grab rails positioned along the corridors and manual handling lifting aids in bathrooms and toilets. There were toilet and bathrooms located near to living rooms. The bathrooms were spacious in size to provide easy access and the baths were specially adapted to assist people. There were also walk in assisted shower rooms for people who use wheelchairs. A bathroom and shower room had been redecorated since the last inspection and there were plans for a shower room to be converted to a bedroom. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: Rooms were spacious in size providing easy wheelchair access. Some areas of the home had been re floored and we saw that the carpeting in the hallway was stained in areas and would benefit from being replaced. Since the last inspection bedrooms have been decorated with peoples personal choice of colour. People have been supported in buying furniture for their rooms and these were seen to be furnished and decorated to reflect peoples different interests. It was evident that staff have been responsible for the decorating of some peoples rooms. This shows their dedication in ensuring people live in a homely environment that meets their needs. There were visual stimulation aids as well as relaxation aids such as wall lights and mobiles seen in many rooms to provide additional stimulation and relaxation. Health and safety checks had been carried out by the staff to ensure the home was being well maintained and a safe place for people to live in. A full time house keeper was employed helping to ensure a good standard of cleanliness was maintained. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are cared for by staff who have a good understanding of their role and responsibilities. People living at the home are now benefiting from a consistent team, with vacancies filled. Some areas of staffs training must be updated to ensure they are informed of current good practice. Evidence: We spoke to a member of staff who demonstrated their knowledge and experience. They had a good understanding of their role and responsibilities, and the needs of the people living at the home. Since the last inspection the home has been using agency workers on a regular basis due to staff vacancies. The manager told us that staff had also taken on extra duties and responsibilities. This was confirmed by staff spoken with. It is clear that the home has been through a difficult period with staff shortages. A survey received from staff included the comment more staffing at times. At the time of this visit there were three support worker vacancies. Since this visit all three vacancies have been filled. A vacancy for a qualified nursing staff has also been filled. We looked at three staff files that showed the people living at the home were being Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: protected through appropriate recruitment practice. Two surveys received from staff confirmed they had undergone checks such as the Criminal Records Bureau (CRB), and references before they started work. We looked at staff training records for all the staff. Records showed that whilst the majority of staff had received training in mandatory areas of first aid and manual handling, there were some gaps for some staff needing refresher training and updates. We saw some staff had received training in areas of peoples needs. This included epilepsy awareness, working with people who self harm and preventing challenging behaviour. A survey received from a health care professional told us I find 121 Watleys End staff particularly caring and devoted to service users there. Staff are really genuinely concerned about people as shown by activities like coming in on their day off for special meetings and decorating service users bedrooms. Care Homes for Adults (18-65 years) Page 21 of 27 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 has undergone a period of instability that is now being addressed. Peoples health and safety is protected. Evidence: Since the last inspection there is a new manager at the home. Ms Ireland has only been at the home for two weeks. She is continuing to manager her previous home for 2 days a week until the new manager has completed their induction. On the day of this inspection Ms Ireland was also having her previous home inspected by another inspector and was having to make trips between both homes. We spoke with Ms Ireland who informed us of her related knowledge and experience. She was able to demonstrate a good understanding of her role and responsibilities and of the needs of the people living at the home. There are processes for audits to be carried out on the home to ensure standards are being met and monitored. Quality Assurance audit tools support managers in visiting homes to check standards. A report is completed with action to be taken. We did not Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: see an action plan or recommendations recorded from the last audit of the home on 21/05/2008. We looked at various records during the visit and these have been recorded in the appropriate standard. We have made requirements for some records to be updated with current information such as some peoples care plans and risk assessments. Monthly monitoring visits to the home had been made by a senior manager in the organisation. We saw records that showed us on some of the visits staff were spoken with and had been observed caring for the people living at the home. Other areas the senior manager examined were staff vacancies, complaints and staff training. We saw records of fire training staff had attended. The fire log book showed fire equipment had been checked regularly. A fire risk assessment had been completed. However it had been identified by the manager that additional information was needed. The manager told us she was booked to attend training in completing fire risk assessments in September 2009. During the inspection the home was visited by the fire authority for a routine fire audit. The manager was given advice by the fire officer in some areas of the home. We saw monthly health and safety monitoring reports and records of accidents and incidents. These processes helped to ensure people were protected and kept safe. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Individual care plans must be updated with current information. This will make sure that the needs of the people living at the home are met and they are supported safely. 28/02/2010 2 9 13 Risk assessments must be updated with current practice. This will make sure the needs of the people living at the home are met and that any changes to risk factors are taken into consideration. 31/01/2010 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 6 19 Develop care plans in an easy read format to help people understand the planning of their individual care better. Train staff in offering people the practice of palliative care. Page 25 of 27 Care Homes for Adults (18-65 years) 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 3 4 5 23 24 35 Updated staff with training in safeguarding aduts from abuse. Replace carpeting to the hallways to help improve the general environment. Update staff with refresher training in manual handling and first aid. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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