Care Home: Allendale

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Allendale 1 Allendale Road Mutley Plymouth Devon PL4 6JA     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: Stella Lindsay     Date: 0 2 0 4 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 29 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Allendale 1 Allendale Road Mutley Plymouth Devon PL4 6JA 01752670247 01752670247 enquiries@comae.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Lilah Ramsden,The Very Rev Mitred Archpriest Benedict Ramsden,Mr Simeon James Antony George Rams Name of registered manager (if applicable) Beverley Ann Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 3. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Mental Disorder (Code MD) Date of last inspection Brief description of the care home 1, Allendale Road is a care home providing personal care (if required) and accommodation for up to three people, over the age of 18 years, with various mental disorders. `The Community of St Antony and St Elias own it. This is a private sector organisation owning several other care homes in Devon. The home was opened in 1993 and is an end of terrace property, located in a cul de sac in the residential area of Care Homes for Adults (18-65 years) Page 4 of 29 3 Over 65 0 care home 3 Brief description of the care home Mutley in Plymouth. All the homes bedrooms are single. None of these have wash hand basins or en suite facilities. There are a bathroom and an accessible shower. There are also a lounge and a kitchen/diner for communal use. On the first floor are a staff office and a separate staff bedroom. The home has small back and front yards and all areas are accessible to the people who use this service. The current scale of charges is #1,604.00 to #1,666 per week. No additional charges are recorded. The Registered Provider provided this information to CSCI in March 2007. Care Homes for Adults (18-65 years) Page 5 of 29 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: The last Key Inspection was carried out from 29th March to 2nd April 2007. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was unannounced and took place on 2nd April 2009. It was carried out by one inspector, but the report is written using we as it was carried out on behalf of the Care Quality Commission. Prior to the unannounced inspection we sent questionnaires to people who live at the home, and to people who work there. Two staff completed and returned these. During our visit we spoke to both people who use the service, the registered manager, and two other staff on duty. The Service Provider sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us all the information Care Homes for Adults (18-65 years) Page 6 of 29 we asked for. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. The Manager had written well about the service that she provides, and also gave us some numerical information about the service. We spoke to staff about the care and support they provide, and looked at care records. We looked at staff recruitment records, training records and policies and procedures. We did this because we wanted to understand how well the safeguarding systems work and what this means for people who use the service. All this information helps us to develop a picture of what it is like to live at Allendale Road. This home is also known as Mutley 2. What the care home does well: What has improved since the last inspection? What they could do better: This home is part of a wider organisation, known as the Community of St.Antony and St.Elias. There are benefits for residents in the social and organisational resources of the group. However, senior management must bear in mind the regulations that are in place for the support and protection of residents. Documents that are gathered during staff recruitment to ensure the protection of residents should be available in each home that the staff member works in. As staff are recruited centrally, and then deployed in the different homes in the group, residents should be involved in the decisions regarding who comes to work in their home. The Manager of this home retains responsibility for the competence of staff working in this home, for example with respect to the administration of medication. Therefore, observations and assessment of competence should be carried out by the Manager of this home, when staff come to work here following assessment elsewhere. The Manager should consult with the Fire Safety Officer with regard to the safety of the kitchen door and the efficacy of battery powered alarms. Care Homes for Adults (18-65 years) Page 8 of 29 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.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 9 of 29 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 29 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. The Manager is able to ensure that people admitted to this home may suitably have their needs met there, with respect to the current residents as well as resources available. Evidence: Information about the Community of St Antony and St Elias is available, including a website. The Manager gave us information about this house. Residents had been given a Servcice Users Guide including a copy of the Complaints procedure, and an Individual Contract. The Manager told us that referrals are dealt with on a Community basis. The normal practice is for two senior workers from the organisation to visit a prospective client in their current home which has recently been as far afield as London and Oxford. Consideration is given to whether the person may benefit from services offered by the group, and then the Manager will consider whether they may suitably have their needs met at this home. Day and overnight visits would then be offered, at a pace to suit the prospective resident. The Manager had recently met with three people who were on Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: referral. Her view that they would not be suited to this house was respected. There had not been any admissions since the previous inspection, apart from the short stay of a resident from another home in the group, already known to the existing residents. Careful consideration was given to this respite period, with full consultation and risk assessment. Care Homes for Adults (18-65 years) Page 12 of 29 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. This service involves individuals in the planning of their own care, and encourages them to make their own decisions and choices. Evidence: We saw detailed and explanatory daily routines recorded in residents care plans, so that staff would know exactly what was required for their well being each day. We saw that these records had been up dated and were in line with the residents current needs. Risk assessments had been drawn up with respect to particular requirements of the current residents, and methods for staff to protect them, and maintain their personal hygiene. Residents ability to make decisions had been considered and recorded. The daily log books, kept by staff to ensure that all important factors or any changes observed can be brought to the attention of their colleagues, had been modified to encourage staff to discuss these with the resident, and to provide a space for the resident to sign to Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: show that they are aware of their right to read their own records. Care Homes for Adults (18-65 years) Page 14 of 29 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. This service ensures that residents are offered choice, and enabled to participate in meaningful activities in the home and the wider community. The routines and activities of the day are person centred, regularly reviewed, and sensitive to peoples changing needs. Evidence: We saw that the residents were supported to live interesting and fulfilling lives, with staff ensuring their safety. During this visit, one resident had been accompanied to a singing group in Totnes, with other people who live in this group of homes. The other resident had been to investigate a neighbouring badminton club, accompanied by a staff member, and though it had not been available on this day, they had been able to check for its appeal and availability. They then attended another social venue. Staff told us they see what people want to do, and do it. One of the residents particularly Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: enjoys walking, and both staff on duty today said one aspect of the job they appreciate is getting out with the residents - Its good to see them achieve something different every day. We recognise peoples preferences and help residents expand their horizons at their own pace. A weekly Activity Plan had been produced for each resident, including household tasks and shopping, as well as regular social activities such as going to the pub. There was also a programme of activities offered weekly by the Community of St.Antony and St.Elias, to which residents had an open invitation. These included crafts, singing, a guitar workshop, ladies swimming, and moorland walks. A Bank Holiday weekend was ahead, and staff and residents were considering whether to invite residents from elsewhere in the Community to join them for a meal, or to visit people in a neighbouring house. The residents had benefitted from holidays provided for them, with staff to accompany them. These were in self catering facilities that had been found to be suitable and attractive, in Cornwall and Exmoor. During this visit, one of the staff and residents who were out together during the morning, chose and shopped for lunch, and prepared it on their return. We all sat round the kitchen table and enjoyed soup and fresh bread. Meal preparation sheets are completed by staff, and these show the variety of meals that are provided, with plenty of fresh vegetables and fruit, and the opportunity for occasional Take-aways. The Manager said that training in Nutrition is planned, including good nutrition for older people, as some residents are getting older. Care Homes for Adults (18-65 years) Page 16 of 29 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 health needs of residents are met, with good multi-disciplinary work taking place on a regular basis. Evidence: We saw evidence in care records of good co-working with health professionals. The organisation employs its own psychiatrist, who had liaised with the residents GP and NHS consultant. Medication reviews had taken place at suitable intervals for each client. Medication is kept in a locked cupboard in a secure room. Each resident has a locker for their current medication, which though not fully meeting the regulations for storage of medication, have been approved by the supplying pharmacist. These are kept in a locked room and carefully supervised. Training for staff with respect to the administration of medication had been reviewed since the last inspection, in order to avid errors. We saw that this training had been provided during staff induction. The Manager had a format for observing and assessing the competence of new staff, but had not used it. Over the past two years since its introduction, staff had come from other houses in the group, having had their Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: competence assessed by other Managers. The yearly audit by the supplying pharmacist had been carried out in January 2009, without finding problems. Care Homes for Adults (18-65 years) Page 18 of 29 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. Residents are protected by staff vigilance on their behalf, and knowledge of risk factors. Evidence: Each resident had been given a copy of the Complaints procedure, and also had been given information about an Advocacy service. Neither the home, nor the Commission for Social Care Inspection had received any complaints since the last inspection. Staff had received training in the Protection of Vulnerable Adults, and were able to tell us the correct action to take in the event of an allegation being made. The organisation is aware of current threats to residents safety of internet social networking, but residents at this home were not interested in using computers. Training on the Mental Capacity Act had been provided, and a session on the Deprivation of Liberty Safeguards was anticipated. Staff had been given booklets on this subject, which the Manager said would be discussed during their individual supervision sessions. Care Homes for Adults (18-65 years) Page 19 of 29 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. 1 Allendale Road is a safe and comfortable house, close to the amenities of Plymouth City centre. Evidence: The house had been painted externally and was looking smart. A hand rail had been fitted by the front entrance, for safety, and white stripes painted along the edge of the steps. We were shown the maintenance book, which showed when problems had been recorded, and when repairs or other action had been taken. The Manager told us that this action was sufficiently prompt to prevent problems, and that the organisations maintenance team phone her to discuss the urgency of any work needed. After consultation with the Fire Safety officer, alterations had been made to the partition to the unused upper floor, to make it safer. There is a comfortably furnished lounge on the ground floor, and a kitchen diner. Windows in the dining area had been replaced. A new shower had been fitted, with a grab rail. There was another bathroom, with a new bathroom suite. The Manager told us that new tiles and shelving were planned. We saw that residents had keys to their bedroom doors, and that they had personalised their rooms. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: Laundry facilities are sited so that dirty items are not carried through the kitchen/diner. A new tumble drier had been provided. There is a contract for the collection of clinical waste. The Safer Food, Better business system of kitchen management had been introduced. The Manager had liaised with the Environmental health Department, and adapted the documentation to make it suitable for this home. Care Homes for Adults (18-65 years) Page 21 of 29 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. Residents are well supported by staff who are motivated, competent, and understand their varied and changing needs. Evidence: We were given a staff rota, which showed that there are always two Support Workers on duty. The Manager is additional to this. The organisation works the same shifts across seven houses, to make it straightforward for staff to move between the houses. The rota was produced at the end of March for the month of April by the Human Resources officer for the company. The means that staff get little notice of their work placements. One staff member told us that they were, more than happy to go where I am sent. The Manager said these arrangements were normally discussed at their weekly management meetings, including discussion of which staff work best with individual service users. She was satisfied with this arrangement because of the quality of the staff sent to the home. When residents views were gathered by the service in 2007, a questionnaire recorded residents saying they should be asked about who should work here. However, we did not see evidence of residents being consulted about changes to staff providing their support. We met with the two staff on duty during this visit. They were confident and well motivated, and very knowledgeable about the care needs of the residents. I enjoy Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: working here, said one, it is rewarding to see the residents make progress. Recruitment is carried out centrally. The Manager told us that adverts are issued three or four times per year, though some staff come by word of mouth and personal recommendation. Applications are sent from the head office in Totnes, and interviews are held there. The home owner told us that managers from all the houses are involved during recruitment and that he thinks it is beneficial for staff to experience work in more than one house. Following successful recruitment, discussion takes place as to which house the person would be best suited to. We saw on the file of a recently recruited staff member, a Record of Prospective staff evaluation from their Taster Day. We consider that this system of centralised recruitment and deployment may result in residents not being involved in decisions about the joining and departure of staff. Anxiety levels of the current residents might make them unwilling to engage in decision making. The Manager said she felt that she has had a fairly settled staff team in place over the past year, and that the residents lives are enhanced by different people coming to support them. Head office supplied us with evidence that the checks needed to assure residents safety had been carried out, though the records required by the regulations to be kept in the home were not present, as they are kept centrally. Copies should be securely stored in the home in respect of each staff member who works there, in order to meet regulations, and because there may be situations which make information pertinent to individual service users which cannot be foreseen centrally. Newly recruited staff are provided with a comprehensive induction training, which is reviewed and updated by the organisation. It currently includes Health and Safety, Food Hygiene, First Aid, De-escalation, Physical intervetion, Infection Control, Medication, Confidentiality, Communication, Developing as a worker, Moving and Handling, Planning and Motivation, Equality, Protection of Vulnerable Adults, and Record Keeping. We saw records of training that staff had received recently, and they told us that they had found it useful, and were keen to attend. We saw records showing that the Manager has held individual supervision sessions with staff, to give them feedback on their performance as well as discuss issues arising from their work. Group meetings are held three times a week, when the staff going off duty hand over to the new team ariving. Staff also told us that they feel able to talk to the Manager at any time Care Homes for Adults (18-65 years) Page 23 of 29 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. This home is well run in the best interests of the residents. Some safety issues needed to be reviewed. Evidence: The Registered Manager is Beverley Jones. She has eighteen years experience of working in care, and has worked for the Community of St.Antony and St.Elias for ten years. She has achieved the registered Managers Award, and is currently working towards NVQ4 in Health and Social Care. She is fully involved as part of the management team of the organisation, in assessment, recruitment and training. The Registered Providers are Mr Simeon Ramsden, Mrs Lilah Ramsden, The Very Reverend Archpriest Benedict Ramsden, and Katherine Finnegan, who trade as The Community of St.Antony and St.Elias. We were told by staff in the home that internal inspections had increased, and this was seen as an improvement, as in better communication and support to raise and maintain standards. We saw reports written following audit visits to the home by the Health and Safety Manager. In the AQAA, we were told that the management team meet quarterly for a Quality Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: Assurance meeting. Questionnaires were circulated to residents in 2007, and a summary of responses reported. These largely reported satisfaction, and also made suggestions about how their lives could be improved. This exercise should be repeated, to give residents an opportunity for continuous in-put to planning. In the AQAA we were told that four of the companys staff have now trained as Moving and Handling trainers, and this subject is now covered in our induction training and also delivered to existing staff. This training had been provided to new staff during their induction training in February of this year, and was to be offered to other staff who missed it last year. The Manager did not know when her training as a trainer would need to be up-dated. The Registered Manager or the Health and Safety Manager for the organisation should produce a chart to show when each staff member needs an update to their mandatory training. We saw that one staff member had fire safety training in February 2009, but did not see others with recent updates. We saw the certificate for the Inspection report following rewiring of the house, dated 09/12/08, the record of servicing of fire extinguishers on 22/05/08. The fire alarms were battery operated, and checked weekly by staff. The kitchen door was pegged open. It was not obviously a fire door, in spite of cooking equipment within and a staircase above. The Manager must consult with the Fire Safety Officer and make any arrangements needed to assure safety in the house. The home owner told us that he had commissioned a professional fire safety risk assessment for the house. One upstairs window was found to open wide, but maintenance records showed that a restrictor had been in place, to assure residents safety. It had been put out of action by recent improvements to the window, and the Manager undertook to reinstate a restrictor to remove any risk of harm. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 42 23 The Registered Manager must consult with the Fire safety Officer and make any arrangements necessary to complete the fire precaution system in order to protect residents from harm. 24/06/2009 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. No. Refer to Standard Good Practice Recommendations 1 20 The Manager should assess the competence of staff coming to this home with regard to the administration of medication, to ensure they are familiar with the medication needs of the residents here. Copies of documents required by Schedule 1 of the regulations should be kept in the home in respect to all staff who work in the home, in order that information pertinent to the care and safety of service users is available. Residents should have more involvement and consultation with respect to staff coming to work in their home, to empower and give them confidence and self esteem. Page 27 of 29 2 34 3 34 Care Homes for Adults (18-65 years) 4 42 Evidence should be clearly available to show that staff have received and up dated their training in mandatory subjects including Fire safety and Moving and Handling. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: 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. 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. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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