Care Home: Ash Lea House

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What the care home does well The home operates a key-worker system, which allows the staff to work on an individual basis with people. The home was well decorated and had the feel of being a real home and not an "institution." The people live in a safe and attractive environment, which is maintained to a good standard and promotes their privacy and independence. The standard of records and record keeping in respect to the people who live at Ashlea was good with planning taking account of peoples` personal preferences and abilities. The home provides good opportunities` for people who live at Ashlea to be involved in the local community What has improved since the last inspection? All the requirements from the previous inspection have been fully complied with by the time of this inspection. There has been a change of registered provider. What the care home could do better: There are no major issues for improvement however the home needs to address any points outlined in the report. Key inspection report Care homes for adults (18-65 years) Name: Address: Ash Lea House Chesterfield Road Alfreton Derbyshire DE55 7DT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Nancy Bradley     Date: 1 2 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Ash Lea House Chesterfield Road Alfreton Derbyshire DE55 7DT 01773521763 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Clearwater Care (Hackney) Ltd care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 14 The Provider may provide the following category of service only: Care home - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning Disability - Code LD 14 places: Physical Disability - Code PD 2 Places. Date of last inspection Brief description of the care home Ash Lea House is a large detached period house set in its own substantial grounds. The home is situated on the edge of Alfreton, which offers easy access to a large range of shopping facilities and amenities. The Home offers accommodation for 14 people with Learning Difficulties, aged between 18 to 65 years of age. The Home has three lounge areas, one of which includes the dining area. The bedrooms are all single bedrooms, except for one double bedroom, and all are of a good size. The kitchen area is accessible to people who live at the home dependent on ability and the activity being addressed there at the time.The Home offers twenty- four staffing, three meals per day, personal laundry, lighting, heating, and a range of social activities.Details of Care Homes for Adults (18-65 years) Page 4 of 28 1 7 1 1 2 0 0 8 14 2 Over 65 0 0 Brief description of the care home previous inspection reports can be found on the Care Quality Commissions website: www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection and took place over a total of six hours. We spoke with the acting deputy manager, care staff and people living at the home. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since the last key inspection. This included the following: The Annual Quality Assurance Assessment (AQAA) that was sent to us by the home. 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 home. Care Homes for Adults (18-65 years) Page 6 of 28 Two people living at the home were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at support plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. Additionally, time was spent in preparation for the visit, looking at the service history and the previous inspection report. Records were examined relating to the people living there and the general running of the home. There were fourteen people living at the home on the day of the visit. We received thirteen completed questionnaires, from people living there who confirmed they were very happy at the home and were looked after by the staff and could not wish to live anywhere else. Three people indicated they would like to speak with us. People had received assistance with completing the questionnaires. We received eleven completed questionnaires from staff all were very positive about the home, were happy and enjoyed working there. We received seven completed questionnaires from relatives who indicated they care their relatives received was satisfactory and Ash Lea was one big happy family. We received a warm, friendly and enthusiastic welcome from the people living at the home. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure that peoples needs are fully assessed and met prior to admission. This ensures that peoples holistic needs are appropriately met. Evidence: The majority of the people who are admitted to the home have their needs assessed by social workers or through the care management system. The single assessment then forms part of the planned care people receive. Also the home undertakes their own individual comprehensive needs assessment. This was in accordance with a recognised care model and provides a comprehensives person centred record of individual needs, including identified strengths and needs, long-term goals, and evaluation. Care management review the care needs on an annual base. Family and carers interests were also recorded. There has been one person admitted to the home since the previous site visit. Information in the AQAA indicates that people coming to live at the home have a contract showing the terms of the terms and conditions within the home. Also they are invited to come and look around the home, spend time there before Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: deciding on whether to go and live there Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a care planning and review system in place, which ensures that peoples individual needs are met Evidence: During the site visit the care plan of one person who lives at the home was casetracked. This was the most recent admission to the home. The registered manager in conjunction with the care staff had compiled the care plan for that person and there was evidence of the care plan being reviewed on a regular basis. The person casetracked had a comprehensive care plan, which was in accordance with their assessed needs and formulated within a risk assessment framework. The care records include peoples goals, achievements, aspirations individual lifestyle preferences and choices. Daily records are also maintained on each person. Care plans were personalised and had been signed by the person or their families. The peoples key-workers go through all the care records with them so people are aware of its content. The home has moved into person centred planning and people living at the home were Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: being involved in their planning and work developing their care plans. Discussion took place at the site visit as to how the home could develop these further. Everyone living at the home have access to the Advocacy service should this be required. During the visit care staff were observed discussing with people, choices and arrangements for daily living. Detailed risk assessments were in place and these included actions to be taken by staff and interventions prescribed by outside healthcare professionals. Risk assessments are individual to the person and also generic covering general activities. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were arrangements in place to enable people to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. Evidence: The care records of two people from the home seen provided detailed needs assessment and care planning information regarding their social, recreational, educational and occupational activities both within the home and outside in the community. Discussions with people from the home during the visit confirmed they were very happy living at the home and they liked the activities offered. Various photographs, which were around the home showed, people having a good time and enjoying themselves. The relationships observed between care staff and people who live at the home appeared open and good-humoured. People at the home told us they have a close relationship with the staff that plays an important part in their lives. The Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: staff encourage the people living at the home to take pride in their appearance and their dress sense is respected. The daily routines are flexible with every one being able to make their own decisions about how they spend the day. One completed relatives questionnaire commented on the lack of activities for people who were not going out on work experience or to the local day centre. Discussions with the people who live at the home indicated they do what they like. Activities are available should they chose to do so. On the day we visited people were out at the day centre, shopping, work experience and engaged in life/social skills. Some of the people living at the home are working to a contact and which gives them free time as well has being engaged in daily activities. People told us they were able to go out to shops, library and cinema as they chose. They were also able to visit the pub leisure centres and places of worship. To enable them to do this the home provides transport. The home regularly takes people out in the evenings to such places as bingo, cinema, social clubs and to late night shopping. People can watch TV in their rooms or many lounge areas in the home. The registered manager has taken people from the home on holiday or short breaks. The people living at the home are encouraged to be as independent as possible taking responsibility for some of the household tasks, like tidying their rooms and keeping the communal living area tidy. Information on peoples records indicated that contact with family and friends were appropriate. Any restrictions on contact are recorded in care plans. People at the home can speak with family and friends by telephone or they can visit whenever they wish. Information from the registered manager showed that the home has also arranged social occasions for family and friends. People living at the confirmed care staff respect their privacy and knock before entering their bedroom. Several of the people have keys to their rooms The home has a smoking area, which is for both staff and people living at the home. People can also have a drink in the home; this is usually under staff guidance and supervision. From examination of the menus the home is providing a healthy well-balanced and nutritious diet. People at the home made positive comments about the meals and said their likes and dislikes are taken into account. During lunchtime everyone was given a choice of menu. We had lunch with everyone at the home. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples living at the home receive personal and health care support in a way, which promotes their independence and is in accordance with their preferences and wishes Evidence: Records seen and discussions with staff indicated that peoples health and personal needs were being met People living at the home were generally healthy and records showed that staff promptly contacted the appropriate medical services. People living at the home are registered and attended services within the community including doctors optician, podiatry, dentist, and audiologist. The home maintains a record of peoples weight as part of maintaining a healthy lifestyle. The medication administration practices of the service were assessed. Peoples photographs were in place on medication administration records confirming their identity. The storage of all medication including controlled drugs was looked at and was found Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: to be satisfactory. The medication is supplied from the local pharmacy. Following a medication review one persons medication had been changed. This change was recorded on the MAR sheet however this was hand written and only had one signature. This was brought to the attention of the care staff, who immediately obtained the Doctors full signature to support that of the nurse. The home was following the new prescribed dosage on the instructions of the nurse. There was no audit rail on the homely remedies kept by the home. The policy on homely remedies has been marked off by the Doctor and includes all of the people living at the home. As discussed with the acting deputy manager the list requires updating as people leave and new people come to live there. Records seen confirmed that all people living at the home have an end of life plan Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure people are listened to and their concerns are acted upon. Evidence: The home has a complaints procedure, which is included in the service users guide which all of the people living at the home have a copy of. The complaints procedure is also displayed throughout the home. The home has developed a format which is accessible to people and they are made aware of how to make a complaint and who they can complain to. Information in the AQAA indicated that the home has received one compliant since the last site visit. This was responded to within agreed timescales. The Care Quality Commission has not received any concerns about this home. The home also keeps a record of compliments from family and friends. The complaints procedure in the policy folder did not show the up to date contact details for the Care Quality Commission. The home maintains a record of all outcomes from any complaints made. People spoken with during the site visit indicated they knew how and who to speak with if they had any concerns or were not happy. The home has regular house meetings where people can voice their concerns and raise issues which are important to them. Information in the AQAA indicated there has been one incident reported under the safeguarding of vulnerable adults procedures since the last site visit. This was investigated jointly by Derbyshire Adult Social Services and the home. Training Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: records seen indicated the majority of the staff have received training or are booked on training for safeguarding of vulnerable adults. The AQAA indicates that there has been two occasions when restraint has been used at the home. Howver information on the training matrix shows that staff have not received formal training in this area. Discussions with the registered manager indicated that staff had received training on de-escalation techniques at the time however it is now out of date. The home operates in accordance with Derbyshire County Council Adults Social Services policy on Safeguarding of Vulnerable Adults. The home also has a whistle blowing policy. People finances were seen and checked. From records seen the home operates satisfactory procedures for protecting people monies. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, well equipped and maintained, which prompts peoples independence. Evidence: We carried out a full tour of the home, accompanied by the acting deputy manager. All communal areas were seen. Peoples bedrooms were inspected with their agreement and all rooms had been furnished to their personal choice and were being personalised. The home was clean, well maintained, well furnished, equipped and well lit and heated. Where personal items, furniture and fittings have been removed for a health and safety reason has been risked assessed and included in peoples care plans. People living at the home stated they were happy with their bedrooms and the home. All maintenance issues are dealt with quickly. The home was free of any unpleasant odours or smells on the day of the visit. The home has effective infection control procedures in place. Records indicated all staff had received training on infection control Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has recruitment and selection procedures in place to ensure that the appropriate staff are employed to care for vulnerable people. Evidence: The home has a good percentage of staff who hold a NVQ level 2 or above. At the time of this site visit staffing levels were appropriate to the care needs of the people who live there The home has a recruitment procedure in place, which ensures that staff appointed are suitable to work with vulnerable people. Several staff personnel records were examined which confirmed that thorough employment checks were carried out. All new staff provides two references, a full employment history, have a clear Criminal Records Bureau clearance and complete a probationary period. From staff recruitment records examined, applicants were providing the days date, month and year as part of providing a full employment history. The home has an induction training programme for all new staff, and this is followed up with the foundation training. The registered manager maintains training record ensuing staff receive training completed training in all of the mandatory areas. However only two staff have received training on Deprivation of Liberty Safeguards (DOLs). Other training undertaken includes Mental Health Awareness, Person Centred Thinking, and Person Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: Centred Risk assessment. All staff spoken with confirmed they have regular supervision and records seen supported this. The registered manager holds regular meetings and records seen confirmed this. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well managed; with staff seeking the views of the people ensuring the home is run in the best interest of the people who live there. Evidence: The registered manager has been in post since July 2007 and has completed the NVQ level 4 for registered managers. The registered manager has a relevant job description setting out her roles and responsibilities. The registered manager has a number of years experience in care and has a qualification to work in the care sector. Discussions with staff and completed staff questionnaires indicated the registered manager was approachable and supportive and open to discussion. The registered manager stated that a process for monitoring care and services provided by the home is in line with the policy operated within Clearwater Ltd. The AQAA indicates quality assurance questionnaires are sent out to relatives and to people who live at the home on an annual basis. From this the home then produces a newsletter to address areas raised in the questionnaires. A more formal analysis of the finding is complied for the senior management of Clearwater. The AQAA indicates Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: there is regular feedback obtained from house meetings and Regulation 26 visits. A senior manager in the organisation undertakes the monthly provider visits. Copies of these documents were made available at this site visit. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to us by way of the AQAA. The homes lift is waiting repair to a safety catch. Systems were in place for the monitoring and maintaining the hot water temperatures. These were examined and found to be within a safe range. The registered manager had completed the AQAA to a satisfactory standard. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 If an alteration or an 28/02/2010 additional medication is necessary on the Medication Administration Record (MAR) sheet, this must always be signed by two staff, dated and state the name of the Doctor authorising the change to the medication. This is to ensure the safety of the person and to ensure the correct dosage is administered 2 23 13 All forms of physical interventions must in accordance with the Department of Healths guidance and only undertaken by staff trained to do so. This is to ensure the safety, to protect the rights of, and in the best interests living at the home. 28/02/2010 Care Homes for Adults (18-65 years) Page 26 of 28 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 20 20 35 The home should maintain an audit trail of all homely remedies it administers to people who living at the home The list of people who homely remedies are administered to and is marked off by the Doctor should be kept up to date. All staff should undertake Deprivation of Liberty Safeguards (DOLs) training Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!