Care Home: 137b Tentelow Lane

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What the care home does well The home continues to provide good quality care for the residents. The staff team is experienced and committed to meeting the needs of each resident. Regular activities are on offer for residents both in the home and in the community. Residents have the opportunity to go on holidays and day trips. What has improved since the last inspection? Information written about the residents such as the care plans and risk assessments were detailed and up to date. Regular medication counts are carried out to minimise medication errors occurring. The previous environmental shortfalls had been addressed. The Manager had developed a short report that included information on improvements that had been made to the home and areas still to be addressed. All maintenance and servicing checks were up to date. What the care home could do better: The flooring on the first floor by a resident`s bedroom was uneven and needs attention. The utility flooring was in need of replacing as it is torn. The rota needs to be reviewed to ensure staff do not work too many days in a row without having a day off. Key inspection report Care homes for adults (18-65 years) Name: Address: 137b Tentelow Lane Norwood Green Southall Middlesex UB2 4LW     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 Middleton     Date: 0 2 0 7 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 28 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 28 Information about the care home Name of care home: Address: 137b Tentelow Lane Norwood Green Southall Middlesex UB2 4LW 02088936635 02088936635 mettlelus@aol.com www.milburycare.com Milbury Care Services Ltd care home 4 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) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 137b Tentelow Lane is a home for four male residents with learning disabilities. The home is a four bedroomed, semi-detached house, located on a busy road between Southall and Hounslow. There are local shops nearby and Southall, Ealing and Hounslow shopping centres can be accessed by car. There is a house car for both 137b and the adjoining care home, (137a). There are no bus or rail routes close by. The adjoining house is for four female residents. There is a joint staff team for 137a and 137b Tentelow Lane. 137b has four single bedrooms. One is on the ground floor and has its own shower. There is a shared toilet nearby. One first floor bedroom is ensuite, with its own bath. The two further bedrooms on the first floor share a bathroom and toilet. The lounge, dining room, kitchen and laundry room are located on the Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 4 Brief description of the care home ground floor. The office is on the first floor. There is a rear garden, which is mostly lawn with a patio area. There are parking spaces for both homes to the front of the house. Fees range from £1,000-£1,300 per resident, per week. 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: 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: An unannounced visit was made on the 2nd July 2009. Before the visit we looked at: Information we have received since the last visit on the 26th July 2007. The Annual Quality Assurance Assessment (known as the AQAA). The AQAA gives the Care Quality Commission evidence to support what the agency says it does well and gives them an opportunity to say what they feel they could do better and what their future plans are. Any changes to how the home is run. The Providers view of how well they care for people. The views of the residents and staff. During the visit we: Talked with the residents, staff and the Manager. Looked at the information about the Care Homes for Adults (18-65 years) Page 6 of 28 residents and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the residents. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the Manager what we found. Care Homes for Adults (18-65 years) Page 7 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 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 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 9 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. New residents are assessed prior to moving into the home to ensure the home can meet the individual residents needs. Evidence: There have been no new admissions into the home for some years. We had viewed the homes pre-admission assessments on previous visits and so we did not look at these during this visit. The Manager confirmed to us that all potential residents would be assessed and they would be encouraged to visit the home to meet with the other residents and staff team. We discussed with the Manager the importance during the assessment process to ascertain if the resident would prefer same gender care support when managing their personal care. The Manager agreed this would be considered and noted. Care Homes for Adults (18-65 years) Page 10 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. Care plans and risk assessments are well maintained and person centred. Residents are supported to make daily decisions about their lives. Evidence: We viewed two residents files. Care plans had greatly improved with relevant information on each resident, such as their health, personal and social needs noted. The information was personal to each resident, with details on their preferred routines and likes and dislikes. We saw on one file that the language used to describe one resident needed to change as it was negative and was a term that might have been used in the past but was not acceptable now. This was brought to the attention of the Manager who agreed this needed to be changed. Care plans are reviewed on a monthly basis and evidence was seen that keyworkers meet with each resident and consider if there have been any changes to their needs. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: Risk assessments had also improved with clear information on identified risks and they recorded how staff needed to support residents to minimise the risks. There were no residents with an independent advocate. All had some level of involvement with relatives. The staff team supports the residents to make daily decisions for themselves. One resident seen had increased their verbal communication and could voice to the staff team what they wanted. Where possible residents are supported to have their own personal money. The Manager had completed, for the Local Authority, Deprivation of Liberty forms for two residents who were not able to have a key to the kitchen which was a room that was now kept locked. The Manager was aware of the need to consider and record reasons why the staff team might restrict a residents freedom of movement. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents take part in various social activities which provides them with stimulation and occupation. Residents are supported to maintain social relationships. The meal provision offers residents a well balanced diet that incorporates their individual preferences. Evidence: The residents take part in daily activities both in the home and in the community. Residents on the day of the inspection went bowling in a group with residents from the care home which is next door. Residents need support from the staff team, as they can not go out in the community alone. Each resident has a weekly plan of activities. One resident spoken with said they enjoyed what they did each day and could choose Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: what they want to do. Residents can go on holidays and day trips are organised. Residents can choose to be in a group for activities but can at times have support on a one to one basis. Residents are supported to attend their place of worship. A male member of staff attends the mosque with one of the residents. The staff team support the residents to maintain contact with relatives. One resident had gone on holiday with their family. Where relatives are unable to visit the home, the staff team take the resident directly to see their family. Relatives are invited to the residents review meetings, which look at the residents needs and is an opportunity to discuss any changes or concerns. Two residents can read and they receive their own personal mail. Interactions seen between staff and residents was positive. Staff were able to understand and communicate with the residents who all have different ways of communicating to people. Resident meetings take place on a weekly basis and this enables residents to receive information and share their thoughts about the home. Menus had been viewed in the care home next door two days earlier and as these are the same for this care home they were not viewed again. There had been an improvement in the meal provision since the last inspection visit. Staff monitor more closely the meals to ensure they are not repetitive and are healthy. Where possible, residents help out with the preparation of meals. One resident said they enjoyed the food in the home and could choose what they wanted to eat. If residents do not want to eat what is on the menu then they can choose an alternative meal. Care Homes for Adults (18-65 years) Page 14 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 receive personal care support in their preferred way. Arrangements for the handling, storage and administration of medication are good. Evidence: We were informed that most of the residents need prompting to manage their personal care. One resident needs full assistance. The majority of the time the support is provided by a male member of staff. When there are no male staff working in the home the female member of staff completes a gender care form explaining why they had to provide personal care. All residents have a GP and see health professionals in the community. Residents are supported to address their health needs. One resident informed us that they had given up smoking. Medical and health appointments are recorded on a form so that staff can monitor the residents health needs and outcomes of visits. We looked at medication for two residents and saw this area is managed well by staff. Medication is locked away and is counted and checked on a regular basis. Those Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: medicines counted were correct.The home has information on the main medicines prescribed for the residents, along with details of the side effects. It was pleasing to see that the staff team had worked hard to reduce the medication used for residents when they are agitated or anxious. The Manager informed us that staff use other ways to calm a resident down rather than administer medication. This can be confirmed as we had received less incident forms that inform us when a resident has needed to be given medication to calm them down. A Pharmacist who had completed a postal survey commented that the residents were looked after well and that the staff team were trained. Care Homes for Adults (18-65 years) Page 16 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. Complaints procedures were in place and residents could voice their concerns if they were unhappy. Procedures were in place to ensure residents were protected from abuse. Evidence: The home had received no complaints. The complaints procedure was seen in residents bedrooms. One resident said they would speak to the Manager if they were unhappy. Although the residents communicate in different ways, the staff team can understand what the residents are communicating to them and can support them if they are unhappy. There had been no safeguarding referrals or investigations. Staff receive training on this subject. The home has the Local Authoritys policy and procedure on safeguarding adults from abuse. The Manager was advised to obtain the updated No Secrets document when it is published. We counted and checked two residents personal money, which were correct at the time of the inspection visit. Residents money is counted at each handover and financial transactions are recorded. Care Homes for Adults (18-65 years) Page 17 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. The maintenance of the home had improved, but there were areas still to be addressed for the benefit of the residents. Evidence: We took a tour of the home and found that the areas identified at the last inspection visit had been addressed. The home now had a new kitchen which was modern and practical. The washbasin and toilet in the main bathroom had been replaced. The residents bedroom door now closed easily. The flooring in the residents en-suite bathroom and main bathroom had been replaced. The en-suite in a residents bathroom had been re-tiled but we did note that there was grout all over the tiles, which was pointed out to the Manager. Work carried out in the home must be of a good standard and should be monitored by the Manager so that any issues are reported and fixed. The flooring in the utility room also was in need of replacing as the lino was ripped in places. The floor by a residents first floor bedroom was uneven and in need of attention. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Attention needs to be paid to the ongoing maintenance of this home so that it is a welcoming and pleasant place for the residents to live in. Care Homes for Adults (18-65 years) Page 19 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. The staff team work well together in the interests of the residents. However staff must not work too many days in a row without having a day off. Good recruitment checks are in place in the home. The staff team are receiving relevant training which enables them to work to a good standard and deliver good care. Evidence: The staff team work well together and understand the needs of the residents. Those staff spoken with were aware of the different needs of each resident and how to work with them. The staff team are from a mix of backgrounds and experiences and have a range of skills and knowledge. New staff study the Learning Disability Qualification and then move on to study for an NVQ. All staff are encouraged to obtain an NVQ. Those staff asked said they enjoyed working in the home. We viewed the rota and found, as we had also done at the inspection two days earlier in the other care home which is next door, that two members of staff were working excessive amount of days in a row, with some of these days being long days. This was raised with the Manager, as although the home has staff vacancies and does not use Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: external agency staff to cover vacant hours, staff must not work too many days in a row. We recognised that it is good practice not to use external agency staff but that staff must work effectively and support the residents safely. The Manager is keen to recruit for a male member of staff and this might solve the issue of covering all of the vacant hours. The home works flexibly, sometimes having an additional member of staff who works across both the homes thus enabling more activities to take place and one to one time with residents. We recognised that this is beneficial for the residents and would be good if this could continue. Staff confirmed that they can rely on each other and seek support or guidance from other staff as and when needed. The Manager does not have a work email address and the staff team do not have access to the internet at work. Internet access would be beneficial for all concerned as staff could keep up to date with online information from various care organisations. The Manager is keen for this to be implemented as it would benefit both the staff team and consequently the residents. We had looked at staff employment files two days earlier at the other homes inspection. The staff team work across both homes and so files were not seen at this inspection. We were aware from viewing a sample of files that the Criminal Record Bureau Checks carried out do not request for full checks to be carried out. Although the checks are enhanced and staff only work with adults, it would be good practice to request for full checks on new members of staff. All other recruitment checks, such as references and employment history details had been in place. We inspected training records. The home has an overall training record of the whole staff team, which enables the Manager to plan future training needs. Individual training records are also on each member of staffs file. Staff had received training on core subjects, such as adult abuse and food hygiene. Staff learn through a variety of sources, such as the L-Box, which is online learning where staff have to work through the course and complete a test to be able to pass the course, or through in-house workshops. The Manager was reminded that training records should also include any in-house workshops attended. The Manager had attended training on the Mental Capacity Act 2005 and was due to also attend training on the Deprivation of Liberty Safeguards. The Manager showed us information he had received on Makaton which is a form of communication using sign language. We saw staff using this communication throughout the inspection visit. The Manager needs to ensure that staff also receive other specialist training in Autism and any other areas he feels is relevant to the residents. We were informed that some staff had received training in Autism but this Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: should be cascaded to all members of staff. We also discussed with the Manager the subject of dementia which might be a subject the staff team would benefit in knowing more about. The results from the returned staff postal surveys confirmed that staff felt that both new and old staff are well trained. New staff receive an online induction from the Provider and the Manager also ensures new staff work through a workbook that we saw on staff files. Staff confirmed they had received an induction when they started working in the home. Care Homes for Adults (18-65 years) Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager is providing clear leadership in the home with staff demonstrating an awareness of their roles and responsibilities. The home is run in the best interests of the residents. Maintenance and health and safety checks were up to date and protected the welfare of the residents. Evidence: The Manager has been in post for several years and has an NVQ level 4 and the Registered Managers Award. Staff commented positively, in the postal surveys, on the support they receive from the Manager. The home involves the views of the residents through a variety of ways. Keyworkers meet with their assigned resident to talk about any issues and to look at their care plans. Resident meetings take place and once a year senior Managers visit the home for an open day where residents and their relatives can talk about their thoughts on Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: the home. The Manager had developed a short report looking at areas of the home where there have been improvements and areas still to be addressed. Servicing and maintenance agreements are in place for facilities and equipment. All fire safety checks and tests are conducted and the Manager is a fire warden. Legionella testing was up to date and the home works to minimise Legionella through the regular de-scaling of shower heads and taps. Care Homes for Adults (18-65 years) Page 24 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 25 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 1 24 23 The uneven floor on the first 31/08/2009 floor by a residents bedroom needs to be fixed. The floor needs to be made safe and fixed to ensure the home is safe for the residents to live in. 2 24 23 The flooring in the utility room needs to be replaced. So that the room is hygienic and pleasant for the residents there needs to be new flooring fitted. 31/08/2009 3 33 18 Staff must not work too many days in a row without taking a day off. To ensure the staff team are effective and not over tired, staff must have sufficient time off in between working several days in a row. 31/07/2009 Care Homes for Adults (18-65 years) Page 26 of 28 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 3 24 33 34 The work carried out in the home, such as the re-tiling of a bathroom, should be of a good standard. The staff team and consequently the residents, would benefit if the home had internet access. It would be good practice, although the staff team only work with adults, to carry out complete checks on new staff when requesting a Criminal Record Bureau Check. It would be good practice for the staff team to receive specialist training in areas such as Autism and any other subject relevant to the residents. 4 35 Care Homes for Adults (18-65 years) Page 27 of 28 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). 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