Care Home: 2-4 St Ives Close

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What the care home does well Staff give information in different ways to help people to understand things better.The staff ask what people want to do, and help to arrange activities and go to places people like.The home makes sure people are healthy and people go to see the doctor if ill and have eye and dental checks.People can choose where to go on holiday and who they want to go with.The home is a nice place to live and it is clean and tidy. What has improved since the last inspection? The care plans have been changed so staff know how to support people.The staff have had training to support people with how people can make decisions and how to help people to make choices. Where people need help to make decisions support is provided from people who know each person. What the care home could do better: Medicines need to be stored in a way which keeps them safe and at the right temperature. Key inspection report Care homes for adults (18-65 years) Name: Address: 2-4 St Ives Close 2-4 St Ives Close Leyfields Tamworth Staffordshire B79 8HL 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: Mandy Brassington Date: 1 3 0 4 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 32 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 2-4 St Ives Close 2-4 St Ives Close Leyfields Tamworth Staffordshire B79 8HL 0182768517 F/P0182768517 h6029@mencap.org.uk www.mencap.org.uk Royal Mencap Society Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Gillian Cox Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 9 9 0 0 care home 9 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 9 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 (LD) 9 Physical Disability (PD) 9 Care Homes for Adults (18-65 years) Page 4 of 32 Date of last inspection 2 2 0 6 2 0 0 9 A bit about the care home 7 people live at the home. It is not far from the centre of Tamworth. It is near to a bus and train service. The home is suitable for people that use wheelchairs. Care Homes for Adults (18-65 years) Page 5 of 32 Everyone has a bedroom of their own. People can bring in their own things. Care Homes for Adults (18-65 years) Page 6 of 32 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 Care Homes for Adults (18-65 years) Page 7 of 32 How we did our inspection: This is what the inspector did when they were at the care home We spent time with people who live in the home and watched how staff provided care and support. We listened to how staff spoke with people. We spoke to some staff that work at the home and asked if they knew how to support people who live in the home. We looked at two care plans to make sure the staff know how to support people in the way they want. Care Homes for Adults (18-65 years) Page 8 of 32 We looked around the home to check if it is a nice place to live. We checked how people receive their medicines to make sure they were safe and receiving medicines they need to keep well. What the care home does well Care Homes for Adults (18-65 years) Page 9 of 32 Staff give information in different ways to help people to understand things better. The staff ask what people want to do, and help to arrange activities and go to places people like. The home makes sure people are healthy and people go to see the doctor if ill and have eye and dental checks. Care Homes for Adults (18-65 years) Page 10 of 32 People can choose where to go on holiday and who they want to go with. The home is a nice place to live and it is clean and tidy. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 11 of 32 The care plans have been changed so staff know how to support people. The staff have had training to support people with how people can make decisions and how to help people to make choices. Where people need help to make decisions support is provided from people who know each person. What the care home could do better Care Homes for Adults (18-65 years) Page 12 of 32 Medicines need to be stored in a way which keeps them safe and at the right temperature. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Mandy Brassington Care Quality Commission Citygate Gallowgate Newcastle upon Tyne NE1 4PA 03000 616161 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 13 of 32 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 14 of 32 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 15 of 32 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 have an opportunity to visit the home before they move in so that they can make an informed choice about whether to live there. Peoples needs are assessed before moving in to the home so that they can be confident their needs will be met. Evidence: There have been no new people move into the home since our last visit, and there are two vacancies. The people who live at the Home have done so for a considerable amount of time, so we did not look at their pre admission records as they date back many years. The registered person told us that the home has a procedure for assessing the needs of people before they move in so that they can ensure their needs will be met. The service has a Statement of Purpose which records how people are supported in the home and what they can expect. These documents are made available to people who live in the home and prospective residents. Care Homes for Adults (18-65 years) Page 16 of 32 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. There are effective systems of care planning and risk assessment in place, which should ensure that peoples needs are understood and met. People receive good support to make choices and decisions about their lifestyles. Evidence: Since our last visit the care plans have been reviewed. The service has used Graphic Facilitation to develop a Person Centred Plan for each person. Graphic Facilitation is where the person is helped to record how they want to be supported by a facilitator using plain English and pictures. People who are important to the person take part in developing the Person Centred Plan. One person has a plan which is based around Objects of reference. The person has very complex needs and the plan has been developed to support his understanding of his environment and daily activities. For example, if a visit to the Doctors or Hospital is planned, the person is given a Stethoscope to hold. Each object is accompanied by a learning log, which records how the plan is developing and the objects of reference can be reviewed to provide a more beneficial clue or stimulus. The AQAA recorded that the Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: learning logs record reactions and opinions of people who use the service to review how successful an activity was. The plans have been written in plain English and use photographs and pictures to support peoples understanding. The manager told us that the style and format of the plans are under constant review to ensure they include information important to the service and are written in a way which is meaningful to the person. People who live at the home have complex communication needs so we were not able to ask their opinions about the care they receive. The Person Centred Plan demonstrates the service has considered peoples capacity and records how choices have been made. The Service has a Quality Assurance System What matters to me in place to monitor the quality of the service and the plans. We looked at one section of this which records how people are supported to make choices. Examples of the areas reviewed include, I am encouraged and supported to understand the choices and discussions that I make and I am given information, support and time to make real choices about the things that affect me and are important to me. Discussion with the registered person and the staff revealed that they record how people are supported to make decisions and this is reviewed with the management team. Staff stated that completing the tool helps them to think about how they are supporting people and helps to look at all the information in the Person Centred Plan and Learning Logs to ensure that they are acting in the best interests for the person. We spoke to five members of staff who all demonstrated comprehensive knowledge of peoples needs, which indicates have been read and understood. Care Homes for Adults (18-65 years) Page 18 of 32 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 live in the home experience a meaningful lifestyle that promotes their independence and reflects their personal choices. Evidence: We looked at activity plans and daily records for two people to see if they had regular opportunities to do things that they enjoy. Each person has a record of the activities they like and those that they dont like. The service has two activity co-ordinators who take the lead role in planning and organising activities. Each month with the support from their key worker, they record what the person wishes to do during that month, for example, buying clothes or visiting family members. An activity plan is devised and includes any planned appointments or usual weekly activities. The staffing provided in the service is flexible to enable people to participate in the activities they have chosen. On the day of our visit, two people were using the train to visit a local to town to buy personal items. The staff reported that the service has its own transport but where possible public transport is used, as the home is conveniently located for bus and train Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: services. Two people were going out within the local community and attending medical appointments and one person went to the local pub for a drink. We found that the range of opportunities available to people are varied within the home and the local community. The daily records that we looked at showed that people take part in a range of activities both at home and in the local community, either in small groups or on their own, with the support of staff. People have an opportunity to attend local day services and college, staff reported that one person attends a cookery class, and people attend a local snoozlem, swimming and a Music to movement class. Around the home and in the Person Centred Plan there are photographs of people involved in activities. The photographs show people joining in their hobbies and interests as well as participating in household chores. One plan we looked at, recorded with photographs, how the person was able to choose how he wanted his bedroom decorated and the furniture he chose to buy. The plans and photographs demonstrated how people are able to participate in everyday activities and make meaningful choices about how they want to spend their time and decisions they make. Care Homes for Adults (18-65 years) Page 20 of 32 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. There are good systems in place to meet peoples personal and health care needs. Medicines are managed so that people receive their medication in a planned and safe manner and storage systems and recording methods are being upgraded to ensure they are kept safe in the home. Evidence: Since our last visit the service has reviewed how they record peoples health needs. Each person now has a Health Action Plan which clearly records peoples health care needs and uses pictures and photographs to support understanding. Staff at the home have made good relationships with health care professionals. We saw specific care plans relating to supporting people with their communication that had been written by Speech and Language Therapists, and records which showed that people have regular contact with healthcare staff according to their individual needs. The outcome of each appointment is recorded so that staff have up to date information about peoples health. One person has recently been diagnosed with a condition which requires further treatment and investigation. There has been a Best Interest meeting with the person as it was assessed that the person did not have capacity to make a decision regarding future health care provision. The Best Interest group made a decision including the person, that staff within the home should receive further training to support the person in the home Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: rather than have unknown people provide support in the hospital. The registered person told us that this will be kept under review. Assessing a persons capacity about individual choices means that where people do not have capacity they can be supported by people to act in their best interest. People are able to have regular checks by opticians, dentists and other health professionals. One person was supported to visit the dentist through planned short visits due to his complex needs. The plan of care including going to the dentist, but not seeing the dentist and becoming familiar with the environment and through small agreed steps progressed to the person being comfortable sitting in the Dentist chair and having a check up. This demonstrates that the service has recognised the persons individual needs and supported them to safely and comfortably receive the support they require. Medication is stored in a locked cupboard on the first floor. The medication keys are stored in a cabinet which is accessible to all staff. The registered person told us that this had been assessed for risk, although the keys are not securely kept by a designated person. It is recommended this be reviewed. Medication Administration Records (MAR) were inspected along with the medication systems. Two people record all medicines given and accompanying each MAR Sheet was a pen picture of each person needs, including medicines and what they were administered for. One person has diabetes and the medication was stored in a locked tin in the fridge. This was discussed with the registered person as the arrangements could not ensure the integrity of the medicines, as the temperature could fluctuate and a record of minimum and maximum temperatures were not recorded on a daily basis. During our visit the registered person arranged for a separate medication fridge to be delivered the following day and stated that suitable procedures would be put in place. Insulin and equipment for testing the persons blood sugars was kept in his room in a tin. The lock had broken and the contents were not secure. The registered person obtained secure alternative facilities during our visit to ensure that medicines are kept securely and systems in the home are safe. Care Homes for Adults (18-65 years) Page 22 of 32 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 benefit from effective procedures that are in place to listen to peoples complaints and safeguard them from possible harm. Evidence: There have been no complaints, either to the home or to us since our last visit. We were told that the complaints procedure is made available to peoples families as due to individuals communication needs it would be highly unlikely they would be able to raise concerns themselves. We talked to the registered person about how they could support people to raise concerns or to identify if people were not happy. The manager told us that they would observe peoples behaviour and body language and review the learning logs associated with the plans of care, as this may indicate how the person reacted to an event. This shows that staff know people well and understand the importance of looking at non verbal communication to see if the person may be unhappy. Discussion with staff revealed people were knowledgeable about forms of abuse and how to respond to any alert. Staff reported they were made aware of the Whistle blowing procedure and safeguarding vulnerable adults. The Annual Quality Assurance Assessment gave information that told us that almost all the staff team have completed or are undertaking National Vocational Qualification Training which includes elements regarding the recognition and reporting of possible abuse. We spoke to two members of staff who told us that they understood the importance of the training so that people could be protected from potential harm. Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: Staff at the home have been given information about the Mental Capacity Act and Senior staff have received training for Deprivation of Liberty Safeguarding Legislation. The Act governs decision making on behalf of adults, and applies when people do not have mental capacity at some point in their lives for specific decisions. The service has demonstrated that it has acted within the guidance for the best interests of people who use the service in relation to receiving medical treatment. Care Homes for Adults (18-65 years) Page 24 of 32 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 home is warm, clean and well furnished. This makes a pleasant environment for people to live in. Evidence: We looked around the shared areas of the home and at the bedrooms of two people. The home was warm and clean, well decorated and comfortable and there was adequate space for people. The bedrooms that we looked at had been furnished according to peoples personal tastes. One plan of care contained a photo story of how the person had chosen the colours to decorate their room and choosing the furniture. One person has a sensory massage chair for personal use which staff reported they enjoy. The service is made up of two smaller homes and has a connecting door along the shared corridor. Each home has its own kitchen, lounge and bathrooms facilities. There is a shared lift to the first floor. Care Homes for Adults (18-65 years) Page 25 of 32 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 are supported by a trained team of well established staff who have good understanding of their needs. People benefit from a recruitment system where checks are carried out to ensure that staff are suitable to work in the home. Evidence: The home operates two day shifts and a night shift and an activity coordinator works across the shifts during the day. The manager reported that the staffing is flexible to allow for activities to take place and the current staffing arrangement meets the needs of the people who use the service. The AQAA recorded that the service recognises that the people who provide support critically influence the quality of service that people receive. The policies and processes in recruitment and training, guide and inform effective recruitment practices that include thorough pre-employment checks, induction and ongoing training to ensure that staff fully understand their responsibilities and how to effectively support people with a learning disability. We looked at staff recruitment records for two new workers. The records showed that checks had been made of the persons suitability to work within the home, prior to appointment including a photograph, an application form, two written references, and a Criminal Records Bureau Check (CRB). This contributes to the ongoing safety and Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: protection of people. The training records demonstrates that staff have an opportunity to complete training in important areas such as supporting people with complex needs, health and safety, and moving and handling. This means that staff are able to keep up to date with their knowledge and skills and are therefore able to safely support people living in the home. The people who live in the home are not able to express their opinions about the staff team due to their complex communication needs. We saw that people spent a lot of time with staff, choosing to sit next to them and talk with people. This indicates that people are comfortable with the staff who work with them. Discussion with staff revealed they had a good knowledge of the plan of care and how to support people Care Homes for Adults (18-65 years) Page 27 of 32 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 benefit from the home being well managed and peoples health and safety is promoted and protected. Evidence: It is evident from observation and discussion with staff, that the manager is enthusiastic and committed to developing a good service. The manager has introduced personcentred care planning into the home to ensure people are able to record how they want to be supported. The manager is experienced and Staff commented they felt valued and part of a supportive team and would have no hesitation approaching the manager. Prior to the Inspection, the manager completed an Annual Quality Assurance Audit (AQAA) for us. The AQAA contained clear, relevant information that was supported by a wide range of evidence. There are systems in place to review the quality of care and service provided within the home. There is a quality assurance system What matters to me, where the staff team Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: report and review actual events for how people including how people are able to make choices, how people can live a lifestyle of their choosing, and how peoples beliefs are upheld and supported. The system enables the service to reflect on the support provided and how the service meets the individual needs of each person. This is reviewed throughout the year and where any shortfall is identified, the management team issue a requirement to address the concern and the service has to meet this within an agreed timescale. This means that people benefit from a receiving a responsive service where the quality of service provision is continually reviewed. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 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 Description 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 Description Timescale for action 1 20 12 Where medicines need to be stored at a specific temperature, suitable storage facilities must be provided to ensure the integrity of the medicines and a daily minimum and maximum temperature needs to be recorded to demonstrate the conditions are correct. 11/05/2010 This will ensure that medicines are safe and suitable to use 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 20 To review the systems for keeping medicines safe and having a designated person in control of the medicine keys. This will ensure that the system is robust and safe. Page 31 of 32 Care Homes for Adults (18-65 years) Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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