Care Home: 14 Colne Road

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What the care home does well The home has a friendly, relaxed and supportive atmosphere. The independence and rights of the people who use the service are given high priority. People who use the service are encouraged to make decisions about their lives and to take appropriate risks with support from the management and other professionals involved in their care. Detailed needs assessments are carried out prior to anyone moving into the home so that the person receiving the service knows the home can meet their needs. Occupational and leisure interests are encouraged. The building is clean and decorated to a very good standard. What has improved since the last inspection? A random unannounced inspection of this service took place in October 2009 to check compliance with the eighteen requirements made at the last key inspection in June 2009. All these requirements have now been complied with. A further six requirements were issued as a result of the random inspection. All of these requirements have also now been complied with and as a result: Care plans and risk assessments are regularly reviewed and updated. There is more detailed information in risk assessments regarding minimising risks for residents. Residents` sexuality is being sensitively addressed in their care plans. The lone working policy has been updated to protect staff and residents at the home. All but one staff member has now attended first aid training. This means that there is always a member of staff, trained in first aid, on duty at the home. What the care home could do better: As a result of this inspection two new requirements and two good practice recommendations have been issued. The two requirements relate to staff training and the accurate recording of medication received by the home. The two recommendations relates to checking staff references and reviewing care plans with residents. Key inspection report Care homes for adults (18-65 years) Name: Address: 14 Colne Road 14 Colne Road London London N21 2JD     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: David Hastings     Date: 1 1 1 2 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: 14 Colne Road 14 Colne Road London London N21 2JD 02083609988 02083609988 14colne@hillgreen.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hillgreen Care Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 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: 6 The registered person may provide the following category of service only: Care Home only - code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home 14 Colne Road is a detached house designed to meet the needs of its residents. It is situated in the Enfield area of North London within walking distance of local amenities. There are six bedrooms. The house has a lounge , dining room, bathroom, large kitchen, utility room, a total of eight toilets. Hillgreen Care aim to provide a home and normal life at 14 Colne Road for six adults between the ages of 18 - 65 years, with learning disabilities, challenging behaviour and autistic spectrum disorders, by enabling then to settle and integrate within their own community, to become accepted and Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 0 7 0 7 2 0 0 9 Brief description of the care home valued as individuals and to enjoy the facilities and amenities available to all people within the community, whilst also providing professional guidance and support to enable then to live independently. Each person is encouraged to exercise their right to choice and take responsiblity for their daily lives, also to do as much for themselves as possible within their daily routine. High standards of support are maintained so as to optimise each persons quality of life. Fee levels for 14 Colne Road range from one thousand five hundred pounds to two thousand two hundred pounds 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: This Key unannounced inspection took place on 11th December 2009. In total the inspection lasted 6 hours. We were assisted by the manager and service manager who were open and helpful throughout the inspection. We spoke with four staff on duty during the inspection. We met the two residents of the home and spoke with one of their social workers over the phone. We were also able to speak with the relatives of the two residents of the home. We observed the interactions between staff and residents. We inspected the building and examined various care records as well as a number of policies and procedures. The home also prepared a self-assessment (AQAA) and this was submitted to the Commission. This information was used as part of the inspection. 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 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 7 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 8 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. 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 and the support they need. Evidence: There have not been any admissions to the home since the last key inspection. We examined the pre assessment information for one of the residents now residing at the home. The service received a detailed pre assessment from the persons placing authority. The service manager and registered provider then carried out their own assessment of the persons needs. This was detailed and contained all the information required by this standard. There was also evidence that the person and their relative had been involved in this assessment. The service manager told us that the person had a number of visits to the home to see if he liked it and a review of his placement took place after six weeks of him being Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: at the home. Previously a placement at the home had broken down. We asked if this had occurred due to lack of information from the placing authority concerned. The service manager told us that pre assessment information had been satisfactory however the placing authority had not provided the home with the support they needed to ensure the continued placement of one of the residents. The service manager said that lessons had been learnt from this situation. 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. People using the service have a detailed plan of care, which is reviewed together with staff and changes made when required. Risks to residents as part of their individual life styles are recorded and reviewed. The management and staff work hard to assist and facilitate residents to make decisions about their life. Evidence: Both residents care plans were examined. These were detailed and outlined the needs and wishes of the residents with information for staff about how to support residents and meet their assessed needs. Care plans also included information for staff about how issues around sexuality are to be sensitively addressed. Parts of the care plan are in pictorial form and a resident at the home confirmed that his key worker asked him about how he would like his care to be delivered. The manager was able to give us examples of how the care plan had been changed to reflect residents comments about their care. It would be useful to include residents comments and some written evidence that they have had input around their care. A Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: new good practice recommendation has been made relating to this in the relevant section of this report. The resident we spoke with confirmed that they were able to make decisions about their life and staff supported them when needed. The manager and the staff we spoke to were able to give examples of how they support residents to make their own decisions, for example, with regard to food and activities of daily living. One person told us, I get up at any time. Risk assessments were in place for the residents at the home. These included risks associated with outings and other activities of daily living. These assessments detailed what action had been taken to reduce these risks while maintaining peoples independence as far as possible. Both risk assessments and care plans were being reviewed on a regular basis and with input from residents and other care professionals. 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. People who use the service are supported to enjoy a range of leisure activities. These activities are based on their individual interests. They are also supported to eat nutritious meals based on their individual dietary needs. Evidence: On the day of the inspection both staff and residents went out bowling. Previously that week both residents had been on a bike ride and had been out shopping. One resident showed us the Christmas tree that everyone was decorating. He told us that he enjoyed the activities on offer at the home. It was clear from observation that residents were being involved and choosing activities they enjoyed. There was also evidence from daily notes that residents help out around the home as part of their activities of daily living plan. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: Neither resident attends college at present however the manager told us this was being planned for both residents in the near future. Both residents have a television and computer in their room. Both residents have regular visitors and one resident often goes home for the weekend. The resident we spoke with confirmed that staff make visitors feel welcome. The service has an open visiting policy. One resident we spoke with told us, The staff are always nice to my family. There is a four week menu plan but this is flexible and residents have input into choosing their meals. On the day of the inspection everyone was eating lunch out as they were going bowling. There was evidence that the service had taken into account the cultural needs of residents at the home. The kitchen was clean and food, fridge and freezer temperatures were being monitored as well as what the residents ate each day. The resident we spoke with told us they liked the food at the home. He said, The food is fine. 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. People using the service receive the care and support they need to maintain their independence. People have good access to health care professionals and their health needs are monitored by the home. There are generally good systems in place to deal with the receipt, administration and disposal of medication at the home. Evidence: None of the residents at the home need support with personal care. Care plans detail how staff are to encourage and prompt people with their personal care needs such as washing and changing their clothes. Residents told us that the staff were friendly and respectful towards them. One resident commented, They all are helping me out. Residents weight is monitored monthly and there was evidence that people have good access to health care professionals such as doctors, dentists, opticians and chiropodists. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: All health care appointments are recorded and follow up action clearly documented. The resident we spoke with told us, My doctor is just down the road. Both residents have an allocated social worker who works closely with the resident and the service. Records were examined in relation to the receipt, storage, administration and disposal of medication. All records were satisfactory with one exception. We noticed that one residents medication chart had been filled out incorrectly. The resident is taking Carbamazepine twice a day however his medication chart, which was hand written, states he is taking this medication three times a day. The manager told us this was an error on the part of staff who had filled out the medication chart incorrectly. We saw that even though the chart says 3 times a day the medication was only being given twice a day so there was no evidence that the resident was taking too much. However this mistake should have been picked up by the person who audits medication. The manager immediately addressed this mistake on the medication chart. A new requirement has been issued that all medication records are accurate and reflect the prescribers instructions. Neither resident currently self medicates. 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. If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. People who use the service are protected from abuse by clear policies and procedures and by a knowledgeable staff team. Evidence: The home has satisfactory policies and procedures in relation to complaints and adult protection. People who use the service told us they had no complaints but knew what to do if they did have a concern. One resident told us, Id talk to the manager. One relative we spoke to told us she had some concerns about the home and had told the manager. The relative said the manager had dealt with these concerns and had sorted them out. There have been no complaints about the service since the last inspection. There is currently a safeguarding investigation taking place regarding a resident who climbed through the skylight in the roof and sustained serious injuries. This is being investigated by the local Health and safety team at Enfield local authority. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: The manager was clear about her responsibilities in notifying the appropriate authorities should an allegation of abuse be made at the home. Records indicated that care staff have undertaken adult protection training. We were able to interview two members of staff during the inspection. They had a good understanding of what adult protection was and their responsibility to report any suspicions of abuse to the manager. Care Homes for Adults (18-65 years) Page 18 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. 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 is clean, safe and furnished and decorated to good standard. Evidence: We looked around the home which has been decorated to a very good standard and it was bright and clean throughout. Residents told us they were happy with their rooms and the rooms we saw at the last inspection had been personalised. There is adequate communal space including a lounge with a television and seating in the kitchen for meals. Communal areas had pictures on the walls which had been chosen by the two residents. There is a key pad device on the front door. The service manager told us this had been fitted because one previous resident had a history of absconding. The manager told us this was not an identified risk for the two existing residents as they only go out of the home with staff. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: All rooms have an on suite toilet and shower. Communal toilets had anti bacterial soap and paper towels to limit the risk of cross infection. The service employs a maintenance person to fix things when needed. The kitchen and laundry areas were both clean and tidy. Records indicated that most staff have attended training in food hygiene and infection control. Care Homes for Adults (18-65 years) Page 20 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. People have safe and appropriate support as there are enough trained and competent 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 to care for them. Evidence: On the day of the inspection there were two care staff on duty for two residents. The manager was also on duty. There is one waking night staff on duty throughout the night. We were able to speak with the night staff in the morning of the inspection. There have been problems with the rota and at the last inspection we noted that staff had worked excessive hours. The night staff said this situation had improved considerably due to two new staff being recruited. Since the last inspection the service has updated the lone working policy to include advice for staff on keeping themselves and residents safe. We observed supportive and friendly interactions between staff and residents and one of the residents told us, They are nice. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: Two staff files were examined from staff recently employed by the home. We checked these files to see if the homes recruitment procedures were being followed so that residents are protected from unsuitable staff working at the home. The files examined contained all the information needed to protect residents including two written references, proof of identity and criminal record checks. In some cases references included a company stamp or letter headed paper to further authenticate the reference. Where references do not include this evidence, it would be prudent for the manager to phone the referee concerned to validate the reference. A good practice recommendation has been issued relating to this. Prior to this inspection the home sent us information about the service (AQQA). This states that two of the six care staff have completed their NVQ level 2 training. The service has highlighted the need to provide more staff with this training. Staff we spoke with were positive about the training the service provides. We examined the training matrix for the home. This showed which staff had undertaken training relevant to their job. There were some gaps in this training and the manager told us she would complete a training audit to identify the further training needs for all staff. A new requirement has been issued that all staff at the home are provided with the training they need to carry out their roles and responsibilities safely and affectively. Staff we spoke to confirmed that they receive regular supervision from the manager and we saw records of these supervisions on staff files we examined. 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. People who use the service benefit from a well run home and a professional manager. The newly developed quality assurance system should ensure that residents and their representatives have a say in how the service is run. The health, safety and welfare of residents are promoted and protected. Evidence: The manager has completed the training required for her management role. Both staff and residents were positive about the manager and said she was easy to talk to. Staff said the manager was supportive and helpful. We spoke with a social worker who had placed a resident at the home. They were positive about the professional approach of the manager. One of the relatives we spoke to told us the manager really puts an effort into making sure that things get done. As this service is relatively new the quality assurance systems have not yet been fully tested. However there are residents meetings so that people can have a say in how the home is run. The manager told us that the service would be sending out quality questionnaires to residents, their relatives and other stakeholders shortly. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: The service manager conducts monthly visits to the home so he can ask residents how they are getting on and it was clear from observation that he has a good relationship with the residents. We examined records in relation to fire safety. Staff go through the fire safety procedures during their induction and this is recorded. The manager told us that further fire safety training has been booked for staff in the next couple of weeks. Records indicated that staff undertake regular fire drills and the fire alarm is tested weekly. The manager said that there have not been any incidents or accidents reported since the last inspection. Records also indicated that staff attend health and safety training in order to keep up to date with infection control, food hygiene and first aid. As mentioned elsewhere in this report, the Enfield Health and Safety unit is currently investigating a serious incident that occurred in the home in June of this year. The outcome of this investigation has yet to be confirmed. Information received from the home prior to this inspection indicated that there is up to date certificates in relation to electrical and gas safety. 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 20 13 The registered person must ensure that all medication records are accurate and reflect the prescribers instructions. This is to ensure that residents get the right medication at the right times. 01/01/2010 2 35 18 The registered person must ensure that all staff at the home are provided with the training they need to carry out their roles and responsibilities safely and affectively. This should ensure that residents are supported by an appropriately trained staff team. 31/03/2010 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 6 The registered person should ensure that written evidence is provided to indicate that residents have been involved in reviewing their care plan. The registered person should ensure that referees are contacted where appropriate to further confirm the authenticity of staff references. 2 34 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). 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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