Care Home: 24 Baveney Road

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 24 Baveney Road 24 Baveney Road Worcester Worcestershire WR2 6DS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Blake     Date: 2 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 24 Baveney Road 24 Baveney Road Worcester Worcestershire WR2 6DS 01905420706 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dimensions (UK) Ltd Name of registered manager (if applicable) Julie Anne Bedford 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: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 4 Date of last inspection Brief description of the care home 24, Baveney Road is registered to provide residential care for up to 4 adults who experience a learning disability. The premises is a large, detached house situated in a pleasant residential area, approximately 2 miles from the City of Worcester, with easy access to public transport and a range of amenities and facilities. The home is owned and run by Dimensions (UK) Ltd., and is part of The New Dimensions Group, which, as the parent Company, provides strategic direction and a range of functional support services. Care Homes for Adults (18-65 years) Page 4 of 30 care home 4 Over 65 0 4 Brief description of the care home The stated purpose of the organisation is, to work with people with learning difficulties, supporting them to make choices and to exercise control over their lives, and the main aim of the home is, to deliver a person-centred response to the needs and aspirations of the people we support. The range of fees is available from the home. A copy of this inspection report can be viewed at the home. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection of the service. We spent three hours at the home, talking with people who live there, and to the staff, and looking at the records, which must be kept by the home to show that it is being run properly. These include records relating to the care of people who use the service. We looked in detail at the records for two people living at the home. The service had previously completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Some of the managers comments have been included within this inspection report. Care Homes for Adults (18-65 years) Page 6 of 30 We also received completed survey forms from people who use the service, staff and health professionals who work with the home. The information from these sources helps us understand how well the home is meeting the needs of the people using the service. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 30 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 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 who are considering moving into 24 Baveney Road have access to clear information about the service. They can be confident that their needs will be assessed before they move in, so that staff will know how to support them. Evidence: The home has a Statement of Purpose and Service User Guide, which explain what life is like at 24 Baveney Road. These documents are not fully up to date, but give useful information about life at the home. We looked at the records for someone who had recently moved into the home. We saw that staff had visited the person at their previous home to find out what support they would need, and their wishes and preferences. We saw records which showed that the home had worked closely with the social care team in planning this persons move into the home. The person had visited 24 Baveney Road on several occasions before moving in, and Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: had had the opportunity to meet the other people living there. The manager told us that she would have preferred it if the person could have had an overnight stay before moving in, but on this occasion, this was not possible. The manager told us how important it is that people already living at the home have the chance to meet new people before they move in, to help them decide if the new person will fit in with everyone else. Care Homes for Adults (18-65 years) Page 12 of 30 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. Peoples individual plans are based on their needs and preferences. The plans are detailed and promote independence. People are consulted on, and take part in, all aspects of life at the home. Evidence: Everyone living at the home has a support plan which gives clear information about how much support they need and how they prefer it to be provided. We saw that people had been involved in drawing up their own support plans, and that their key workers had also been involved. The support plans seen on the day of the inspection were detailed and person centred. This means that they concentrate on what is important to each person from their own perspective. The plans emphasise the fact that people are supported to make choices about every aspect of their lives. For example, we saw that one person is supported to do their own shopping and to choose the food that they want. If people need support to enable Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: them to make choices, this is provided sensitively. We saw that one persons plan states X (name of person) needs reminding of weather conditions as to suitable clothing to wear. In our surveys, people told us that they make decisions about what they do each day. On the day of the inspection, we saw that, when someone rang the doorbell, a staff member supported one of the people living at the home to answer the door. When we arrived, we were welcomed with a handshake by one of the people living at the home, and a staff member then supported them to make a hot drink for us. This shows that people who live there view 24 Baveney Road as their own home, and are encouraged and supported to welcome visitors. In the AQAA, the manager told us The people at Baveney Road are always offered a choice and are encouraged to make as many decisions for themselves as possible. This was confirmed by the inspection. We saw records which showed that people are supported to be as independent as possible. Where this might pose a risk to the persons safety or welfare, the home carries out detailed risk assessments. We saw that one person enjoys horse riding. The risk assessment clearly showed the potential risks and how these are managed to ensure the persons safety. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have opportunities to take part in a range of activities, although this is sometimes limited by the number of staff available. The home respects peoples individual rights, and contact with their families is supported. People have access to a varied diet, which is balanced and nutritious. Evidence: There is a wide range of leisure and social opportunities for everyone living at the home. These are written onto a weekly planner so that it is easy to see what is going on at any time. We saw records which showed that people are encouraged to pursue activities which match their interests. One person living at the home has an interest in wildlife, and the home has arranged visits to wildlife parks and also has an aviary of canaries and doves Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: in the garden, which the person is supported to be involved in. Dimensions organises regular activities, including a fortnightly disco and a weekly cookery session. These activities enable people to meet up with other people living in the organisations other homes. The manager told us that one person living at the home has begun to form a friendship with someone who lives at another home nearby, and staff are supporting them to build this friendship. On the day of the inspection, a new fast food restaurant had opened locally, and we saw that people living at the home had taken the opportunity to visit it to join in the opening celebrations. Records showed that people are supported to maintain contact with their families, if they wish to. The manager told us that she has made a DVD of one persons achievements, so that their family can see how much they are able to do for themselves. We saw from the records that people are supported to attend a place of worship if they wish to. One persons support plan stated X (name of person) goes to church on Sundays if she wants to. The persons daily records showed that they attend church at least once a month. In the AQAA, the manager told us The people at Baveney Road are supported to participate in many activities. We saw that some activities had not taken place as planned, and the manager told us that this was due to staffing levels, which meant that there were not always enough staff to take people out. She told us there are days when people miss out on their activities because of staffing levels. We saw that supper was being cooked by people living at the home with the support of staff. The fridge and cupboards contained a variety of food, and the manager told us in the AQAA The people at Baveney also individually shop for their food. This then gives every one the opportunity to put what they want in the trolley. From their choice at shopping this then gives them the decision of what they eat. Care Homes for Adults (18-65 years) Page 16 of 30 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. The home makes sure that peoples personal and health care needs are identified and monitored. People usually receive the help and support they need. Their medicines are managed safely by the home on their behalf. Evidence: As part of the person centred planning at the home, each person has a Health Action Plan. This identifies their health and medical needs, and sets out in detail how these will be met. We saw records which showed that the home seeks advice from health professionals, such as the Speech and Language Therapist, where necessary, and that advice from these professionals is recorded and acted upon. We looked at one persons Health Action Plan. Most of the plan had been completed, and the records clearly showed that medical appointments had been made and attended as necessary. We saw that the plan stated to go to the dentist every six months. The last visit to the dentist was almost a year ago, and the records showed Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: that, at that appointment, the person would not allow the dentist to look at their teeth. The manager told us that she would make an appointment for the person to visit the dentist as soon as possible. We saw that the Health Action Plan included a page for mens or womens specific health needs, and that this had not been completed. This means that the person could miss out on important health checks. Peoples plans stated clearly how they prefer to be supported with any personal care, and emphasised the importance of promoting privacy and dignity at all times. We saw that the home keeps accurate records of all medication. Some people living at the home have medication which is only given as required, rather than on a regular basis. We saw that the home has clear guidelines for staff on when this medication should be given. Each persons records include details of all their medication, why it is being used, and the possible side effects. We saw that only staff who have received training are allowed to administer medication. One person has an allergy to a particular type of medication, and this was clearly highlighted on both their support plan and their medication records. Care Homes for Adults (18-65 years) Page 18 of 30 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 who live at the home and/or their representatives can express their views about the home and feel confident that any concerns would be dealt with appropriately. Staff understand their responsibility to promote peoples welfare and protect them. Evidence: The home has a clear complaints procedure, which is available in a pictorial format that makes it accessible to people with a learning disability. We, the commission, have not received any complaints about the home since the last inspection. The manager told us in the AQAA There have been no formal complaints made at Baveney Road, Only compliments given. In our surveys, people told us that they knew who to talk to if they had any concerns. The homes system of providing everyone with two key workers means that people who live at the home are able to talk to someone who knows them well and will support them and advocate for them. We looked at staff records, and found that staff are recruited in a way which protects the people living at the home from unsuitable staff being employed. The home carries out POVAFirst and Criminal Records Bureau (CRB) checks on all new members of staff. POVAFirst checks confirm that a person is not banned from working with vulnerable Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: adults, and are used so that a care worker may start work in a care home before a CRB check has been received. Staff training records showed that staff receive training in the protection of vulnerable adults. The manager demonstrated a good understanding of ways in which people can be protected from neglect or abuse, and is familiar with the local guidelines for reporting any concerns. Care Homes for Adults (18-65 years) Page 20 of 30 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 kept clean and tidy, and staff understand how to prevent the spread of infection. Evidence: 24 Baveney Road is a large detached house in a quiet road on the outskirts of Worcester. It has a friendly and welcoming atmosphere. The lounge has large windows overlooking the garden, and is furnished with comfortable seating and a large television. The dining room, where everyone congregates for meals, also has a music keyboard and some sensory equipment. The manager told us that the table is sometimes pushed back for dancing, which one person particularly enjoys. The manager asked two people if we could look at their bedrooms, and they accompanied us and showed us their rooms. We saw that both bedrooms were clean and tidy. One person had recently had their bedroom decorated, and the manager told us that she had provided paint colour charts so that the person could choose their own colour scheme. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Although one person had only recently moved into the home, we saw that they had family photos and other personal items in their bedroom, which made the room more homely. We saw that staff only enter a persons bedroom if they are accompanied by the person whose bedroom it is. People living at the home are supported by staff to keep their bedrooms clean and tidy, and to do their own laundry. We saw that the home had carried out risk assessments which showed that it was not considered safe for people to do their own ironing. Throughout the home, we saw photos of people enjoying activities such as trips out and cookery sessions. The back garden is large and mainly laid to lawn, with overgrown borders. It is not easily accessible for anyone with mobility problems, as there are stone steps, and the lawn is uneven. The manager told us that they use the front garden for barbecues and for sitting out in the summer, as people do not like the back garden. The manager told us that she is hoping to work with the Probation Service to get the garden landscaped. During the inspection, we saw that staff were using infection control measures such as hand washing and making sure that the kitchen was kept clean and all waste was safely disposed of. Care Homes for Adults (18-65 years) Page 22 of 30 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. Staff are kind and caring, and work in the best interests of the people living at the home. The home has robust recruitment procedures, which help to ensure that only suitable staff are employed. Staff receive regular training, to give them the skills and knowledge they need to work at the home. Evidence: We saw that staff were kind and respectful to everyone they support. People living at the home were very much at ease with the staff. Although people at 24 Baveney Road are not able to communicate verbally to any great extent, we saw by their facial expressions and smiles that they enjoyed the company of the staff. People living at the home are protected by the staff recruitment and selection procedures at 24 Baveney Road. Records showed that the required pre-employment checks are carried out on all staff before they begin work. We saw that one person living at the home is employed by Dimensions to take part in the selection of new staff, at a meet and greet sessions, where they are supported to ask questions of the applicant. Dimensions has a thorough induction process, which ensures that new staff Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: understand their role and have the necessary skills and knowledge to carry out their work. Training records showed that Dimensions offers a wide range of training opportunities. We saw that staff have received all the required training, and the manager told us that staff will soon be attending training in Signalong, which is a form of communication designed to help people with communication difficulties. The manager told us that Dimensions policy is to have a ratio of one member of staff to two people supported by the service when they are at the home. The ratio is one member of staff to one person supported by the service for any activities which take place outside the home. We saw that someone who has recently moved into the home had been assessed at their previous home as having challenging behaviour. Records from the previous home showed that they had been aggressive on more than one occasion. On the day of the inspection, the staffing rota showed that this person and one other person living at the home would be left in the sole care of one member of staff for some hours during the afternoon. Although this person had not exhibited any challenging behaviour since moving into 24 Baveney Road, there was no documentation to show that this had been recognised as a possible risk. We would expect to see that a risk assessment had been carried out, and a plan put in place to manage the risk. On this occasion, people living at the home and staff could have been put at risk of harm or injury. We saw that the home does not have a lone working policy, which might have given guidance as to how to manage the situation. The manager told us in the AQAA we have had staffing levels reduced in the last six months, which has made the service difficult to meet the social needs of the people living at Baveney. The staffing rotas showed that there are usually only two staff on duty during most of the day. The manager is also on duty, but she has administration and management tasks, which mean that she is not always available as an extra member of staff to support people with their activities. The low numbers of staff during the day mean that people may not be able to take part in activities or outings as they wish. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run by an experienced manager, who works hard to ensure that the best interests of the people living at the home are always at the forefront of any planning. Evidence: The manager is registered with the commission, which means that she has been judged to have the knowledge and skills necessary to run the home. The home is clearly run so that the needs and wishes of the people living there are the starting point for all planning. We saw that people living at the home are fully involved in all decisions about the home, such as the decor in the communal areas. Each person living at the home has the opportunity every year to complete a PATH. PATH is a process of planning for people to achieve their goals in life. Each persons PATH is used as part of the planning for the home, which in turn is used to plan the future of the organisation. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: We saw that reviews are carried out regularly, and that all records are kept to a good standard. Staff told us that they receive regular supervision. One staff member told us in a survey monthly supervisions are carried out to assess how we are working and to address any concerns on either side. I find these very useful. We were not able to look at the homes Health and Safety policies and procedures. The manager told us that she had revised them and had sent them to the Dimensions head office in October last year for checking. They had not yet been sent back to her. The manager told us that she would make sure that the policies and procedures were available in the home. Health and Safety procedures give the staff the information they need to make sure that people living at the home are protected from the risk of harm or injury. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 12 16 (2)(m) You must ensure that 31/03/2009 people can take part in activities which meet their needs. This is so that they can lead their lives as they choose. 2 19 13 (1)(b) You must ensure that 31/03/2009 people have access to the health and medical care that they require. This is so that they are supported to maintain their health and wellbeing. 3 42 13 (4)(c) You must ensure that the risks of having staff working on tneir own are assessed and recorded. This is so that people can be kept safe. 31/03/2009 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. Care Homes for Adults (18-65 years) Page 28 of 30 No. Refer to Standard Good Practice Recommendations 1 42 You should ensure that health and safety procedures are available for staff to refer to, so that staff know how to protect people from the risk of harm or injury. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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