Care Home: 85 Park Road

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What the care home does well Staff had the specialist skills and experience to meet service users needs. All staff were trained to use different communication techniques; this would ensure staff could communicate effectively and understand people`s needs. Each service user had a detailed plan of care that recorded their needs, preferences, likes and dislikes; this ensured they would receive the care they both needed and wanted. Service users were consulted regularly about what made them happy and sad and what they wanted to do; action had been taken to respond to any concerns. Service users were able to make choices and decisions about their lives and different activities and entertainments were enjoyed in the local community and at home. Service users and staff got on well together and the atmosphere of the home was friendly and relaxed; staff were alert to any changes in service users behaviour, mood and general health and had responded appropriately The meals were varied and nutritious and met service users dietary needs and preferences. The home had been designed to cater for younger people with sight and hearing loss and it was clear that much thought had gone into providing a suitable home that was pleasant and safe to live in. Bedrooms were comfortable and personalised and reflected individual personalities. Staff were provided in sufficient numbers to meet service users needs in a flexible way. What has improved since the last inspection? The manager of the home had been registered with the Commission since the last inspection visit; she has appropriate qualifications and experience and keeps her skills and knowledge up to date. Service users were now provided with a jacuzzi bath in their en suite; hydrotherapy sessions were enjoyed by service users. What the care home could do better: The way in which new staff were recruited needs improvement to ensure service users were not at risk. Records relating to staff recruitment need to be available in the home for inspection to help determine whether a safe recruitment process had been followed. The temperatures of medication storage areas needs to be monitored to ensure medicines were stored correctly and remained effective. Clear directions should be recorded to ensure service users received their treatment as prescribed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sense 85 Park Road Accrington Lancashire BB5 1ST     The quality rating for this care home is:   three star excellent 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: Marie Matthews     Date: 0 4 0 2 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: Sense 85 Park Road Accrington Lancashire BB5 1ST 01254397937 01254397274 jacqueline.dickinson@sense.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Sense, The National Deafblind and Rubella Association Name of registered manager (if applicable) Mrs Jacqueline Dickinson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: The registered person may provide the following category of service only: Care home only: Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Sensory Impairment: Code SI The maximum number of people who can be accommodated is: 5. Date of last inspection Brief description of the care home 85 Park Road provides 24-hour residential accommodation and personal care for 5 younger adults (aged 18 to 65 years) with sensory impairment, physical disabilities and learning disabilities. The home is part of the larger organisation of Sense, which is the largest specialist voluntary organisation in the United Kingdom working with people with deaf blindness and associated disabilities. Park Road is a detached purpose built house located in a residential area of Accrington. Care Homes for Adults (18-65 years) Page 4 of 30 5 Over 65 0 care home 5 Brief description of the care home It is within walking distance of shops, a public house and a park. There are good public transport links nearby and the home provides mini-bus transport for service users. Outside is a pleasant garden with patio areas, a swing and outdoor seating; there is parking for four cars at the front. Communal areas are bright and comfortable. All single bedrooms are personalised and spacious with ensuite toilet, wash basin and jacuzzi baths. There is a staircase to the first floor. Information about the services offered by the home is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective residents and their families. On the day of the inspection the weekly fees ranged from £1709.82 to £1921.50. Items not included in the fee include some activities and personal items. 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: three star excellent 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: The key unannounced inspection, including a visit to the home, took place on 4th February 2009. The last inspection on this service was completed on 29th January 2007 with an annual service review on 6th February 2008. The inspection process involved looking at records, a tour of the home and discussions with the registered manager and human resources manager. Information was also include from two staff surveys. We were sent the annual quality assurance assessment (AQAA) before the inspection visit; this gave us a good picture of what has improved over the last twelve months and where further improvements were needed. The inspection looked at things that should have been done since the last visit and a number of areas that affect peoples lives. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 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. 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 8 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were given information about services offered by the home to help them to decide whether it was the right place for them. Detailed information was collected about prospective service users before admission to determine whether they could be looked after properly. Evidence: The information about 85 Park Road had been reviewed to inform people about available services. The information needs to include a copy of the terms and conditions, a summary of the most recent inspection report and to reflect recent changes to en suite facilities. The registered manager advised the information was available in other formats; a brochure and photographs of the home were also available for people. There had been no new admissions to the home since the last key inspection; the registered manager described the admission process and provided good evidence to support that detailed information was collected about prospective service users before Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: they were admitted. The process involved meeting the service user and people who were important to them and collecting information information from other specialists or advocates; this would help to determine whether their needs could be met at the home. Prior to admission people would spend time at the home meeting staff and others who lived there; this would help them to decide whether 85 Park Road was the right place for them. Training records and survey information showed that staff had the specialist skills and experience to meet service users needs. All staff were trained to use specialised communication techniques; this would ensure staff could communicate effectively and understand peoples needs. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users were involved in making decisions about their lives and given support where needed. Evidence: The individual care plans detailed service users individual needs, preferences, likes and dislikes; this ensured they would receive the care they both needed and wanted. The plans focused on promoting independance, improvements and positive behaviours; this showed that the service was committed to improving outcomes for service users. The plans recorded the service users communication needs and the different methods that would allow service users to participate and to make their needs known. Any risks had been assessed with strategies in place to keep people safe whilst encouraging independence. It was clear that service users were involved in decisions and choices about their lives; records showed when decisions had been taken by Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: others and the reasons behind this. Service users were consulted regularly about what made them happy and sad and what they wanted to do; action had been taken to respond to any concerns. The plans had been updated regularly to reflect current care needs and preferences; the deafblind person and significant others such as key workers, families, advocates and care managers had been involved. Record showed that peoples money was managed safely. Staff were supported by clear procedures relating to maintaining confidentiality and records were accurate and secure. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users were able to make choices and decisions about their lives and supported to develop their life skills. Social, educational and recreational activities met service users individual needs and expectations. Service users received a healthy nutritious diet that was suited to their dietary needs and expectations. Evidence: All service users had a weekly leisure and educational activities planner; the plans were in line with their preferences and abilities. Service users were able to choose how to spend their days and various methods of communication were used for them to indicate their preferences. Some life skills activities were monitored to ensure they were providing service users with appropriate skills. The individual plans included detailed information about service users routines, likes, Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: dislikes and preferences; this would ensure they received the care and support they both needed and wanted. Records showed that a range of activities and entertainments were enjoyed in the local community and at home. Public transport or the homes minibus was used and staffing was provided in sufficient numbers to provide appropriate support. Service users were able to continue with their education and to take up appropriate employment. Service users were supported with maintaining links with their family and friends and staff often accompanied them on daily or longer home visits. Annual holidays were planned for each service user taking into account their needs, preferences and abilities. Service users choices and rights were respected by staff in various ways such as flashing lights indicated requests to enter bed rooms. Staff were observed interacting with service users in a friendly and encouraging manner; the atmosphere of the home was friendly and relaxed. Individual plans recorded information about dietary needs, likes and dislikes; this ensured service users received a diet that met their dietary needs and preferences. Menus showed that meals were varied and nutritious and service users were offered choices; one staff confirmed that service users could eat alternatives to the menu and dine at a time they preferred. Some service users were involved in shopping for and preparing food, others would participate with washing and tidying plates. The lunchtime meal for service users and staff was enjoyed, relaxed and unhurried; staff gave support and assistance when needed. 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. Service users health and personal needs were met. Evidence: Records showed that service users received health and personal care based on their needs and preferences. Routines were flexible and service users were able to choose how they spent their day. There were technical aids and equipment to help maintain service users comfort and to promote independance wherever possible. Each service user had a health care plan that showed their health had been monitored and advice and support obtained by health care professionals when needed. Staff were trained in health care matters. The service ensured service users received consistent care by providing a designated key worker, detailed information about routines and preferences and establishing good links with advocates, family and friends. Records showed that key workers were alert to any changes in service users behaviour, mood and general health and had responded appropriately. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Medication procedures provided staff with clear and safe guidance. Records were clear and accurate although directions on medication administration charts (MAR) need to be clear and not state as directed to ensure medicines were given as prescribed. Medicines were stored safely although temperatures of storage areas need to be monitored to ensure medicines are stored correctly. Staff had received training to ensure they could manage service users medicines safely. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear procedures and staff awareness ensured service users best interests were protected and they were safe from harm. Evidence: The complaints procedure was clear and available in other formats; this would ensure people understood the process. There had been no concerns or complaints since the last key inspection and a recent survey indicated that people were happy with the standards of service provided. Any concerns or complaints would be monitored and investigated by a senior person from head office; the information would be used to improve the service. During the visit staff were observed responding positively to any changes in behaviour or requests from service users; this would ensure they were safe and looked after and their needs would be responded to. Procedures, care records and training ensured staff had the skills and knowledge to respond appropriately to any verbal and physical aggression; this would ensure people were safe and service users best interests were protected. Key workers had monthly meetings where they review situations that have made service users happy or sad; the key worker would act on service users behalf and Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: bring any concerns or complaints to the registered managers attention. Safeguarding procedures were in place to help staff to protect service users from harm. Records and survey information showed all staff had received appropriate training to help them to recognise and respond to abuse, harm or neglect; this would ensure staff had the skills and knowledge to protect service users. There were whistleblowing procedures that supported staff to act in service users best interests and report any bad practice within the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users were provided with a pleasant, homely and comfortable environment that met their specialised and individual needs. Evidence: 85 Park Road was accessible, safe and well maintained. It had been designed to cater for younger people with sight and hearing loss; it was clear that much thought had gone into providing appropriate aids and adaptations to meet peoples specialised needs. All areas were clean, bright, spacious and free from unpleasant odours. CCTV was in place for external areas only. Service users were comfortable and relaxed and able to wander freely in any area of the house. Each service user had a spacious en suite single bedroom to ensure their privacy; the bedrooms were comfortable and personalised and reflected their personalities. All en suites had recently been refurbished and were now fitted with a jacuzzi bath, toilet and washbasin; hydrotherapy sessions were enjoyed by service users. Doors were lockable and flashing door bells were in place to promote privacy. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The laundry was appropriately equipped and suited to the size of the home. All staff were provided with infection control training; this would ensure staff were aware of the required standards of cleanliness. All areas of the home were clean and fresh and provided a pleasant place for service users to live. 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 were competent, supported and provided in sufficient numbers to meet service users needs in a flexible way. Recruitment processes need to be improved to ensure service users were not placed at risk. Evidence: Records and survey information showed that staff were provided with appropriate induction and ongoing training to develop their skills and knowledge and to help them to meet service users needs. All staff had achieved a recognised qualification in care and had also received additional training to help them to understand and respond to service users specialised needs and behaviours. Staff were aware of their roles and responsibilities and the homes policies and procedures; this ensured service users would be looked after properly. Staff were provided in sufficient number to meet service users needs and additional staff were provided when needed; this ensured the service was flexible to peoples needs. The team included staff of various ages and gender to be able to respond to service users needs and they were able to develop relationships that would provide service users with a friend they could trust and rely on. Staff were seen responding to Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: service users in a friendly, encouraging and respectful manner; service users were happy and content. Two staff files were looked at in detail. It was impossible to determine whether a safe recruitment process had been followed as records and checks were missing from the files. The registered manager and head office understood there was an agreement permitting storage of all files at the head office. Further investigation indicated this was not the case. The personell department was contacted and advised that all recruitment checks were in place for the two staff files although one member of staff had commenced work prior to a satisfactory police check being obtained; failure to follow safe recruitment procedures could put service users at risk. A meeting with the company directors was to be arranged to discuss storage of records. It was recommended that a checklist of records should be stored in the home; this would satisfy the registered manager that all checks were in place prior to employment and that staff were suitable to work at the home. Records and surveys indicated that staff received regular support from their manager; this would help to identify whether staff needed further training and support. The staff group met regularly to discuss various issues and to help them to keep up to date with any changes. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefited from a well managed service that sought their views and opinions to help improve the service. Evidence: The registered manager is Jaqueline Dickinson; she has appropriate qualifications and experience and keeps her skills and knowledge up to date. She is involved in budgetary decisions and ensures people receive a good standard of service. Staff performance was monitored to identify whether they require any further training or additional support and regualr meetings allowed them to air their views and concerns. There were systems in place to obtain peoples views and opinions about the service. Annual surveys were sent to care managers, relatives and staff and the results from this were used to develop the service. Service users expressed their views in many ways through action, sign, body language and behaviour; staff were attentive and Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: acted on their views. Annual family days were held; this gave people further opportunity to air their views. The way in which the home was run was monitored each month and records of any action needed to be taken to improve the service were maintained. The registered manager was supported by senior managers and other key people within the organisation. The annual quality assurance assessment (AQAA) was sent to us before the inspection. This was fully completed and contained excellent information about the service; it was clear that the manager was aware of how the service could be further improved. Records showed that staff had a good understanding of equality and diversity and this had been put into practice. One staff survey indicated recent training had included equality and diversity and sexuality and relationship training; this would help staff to meet service users needs. Policies and procedures were reviewed and kept up to date; this ensured staff had access to clear and safe guidance that would keep them and others safe. Working practices within the home were safe and staff were provided with regular training to ensure they and others were safe. Records showed the home was well maintained and systems were serviced regularly to ensure peoples health, safety and welfare were protected. 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 34 19 Staff must not commence 11/03/2009 working at the home until all the required recruitment checks are in place. This protects service users from being cared for by unsuitable people. 2 34 17 Recruitment records, as 11/03/2009 listed in schedule 4, must be held in the home and available for inspection. This would help determine whether a safe recruitment process has been followed. 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 1 The information about the home should include a summary of the last key inspection, updated information about changes to en suite facilities and a copy of the terms and conditions; this will ensure people are aware of their rights and obligations and are kept up to date with any changes. Page 28 of 30 Care Homes for Adults (18-65 years) 2 20 Temperatures of medicine storage areas should be monitored to ensure they were stored correctly and to maintain their effectiveness. Directions on the medication administration record should be clear to ensure service users receive their treatment as prescribed. A checklist of recruitment records and checks should be maintained to determine whether a safe recruitment process has been followed. 3 20 4 34 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). 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