Care Home: Ashness House

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What the care home does well The home offers a committed specialist service for people with mental illness. This includes offering specialist support for people from forensic mental health backgrounds and for people with mental health and drug and alcohol histories. This specialism has been recognised by the local authority and health authorities. There was good evidence that residents` wellbeing has improved since living in the home. Residents are treated with respect and supported ably and knowledgeably by the staff team. The Registered Person`s specialist knowledge and leadership has helped the service provide a niche service in this part of North London. What has improved since the last inspection? This is the service`s first inspection since its new registration as a limited company and with increased beds (registered in August 2009). What the care home could do better: The home must ensure that it has a good system in place for checking gaps in employment by for prospective staff. Key inspection report Care homes for adults (18-65 years) Name: Address: Ashness House 286 Philip Lane London London N15 4AB     The quality rating for this care home is:   three star excellent 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: Margaret Flaws     Date: 1 1 1 2 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 26 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 26 Information about the care home Name of care home: Address: Ashness House 286 Philip Lane London London N15 4AB 02088010853 02083615573 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashness Care Ltd Name of registered manager (if applicable) Nicholas Dominique Purchase Type of registration: Number of places registered: care home 5 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: 5 The registered person may provide the following category of service only: Care Home only - code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home The home is registered to provide care and support to five people with mental disorder, between between the ages of eighteen and sixty five years. The home is in Tottenham, with easy access to public transport and local shops. It is a spacious family home terrace, on a domestic scale, and it fits with in well with the surrounding area. it has five bedrooms, with a shared lounge, kitchen, dining area and Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 5 5 Brief description of the care home rear garden. The statement of purpose states that the aim of the home is to provide a safe, structured, pleasant and homely environment for people with a history of mental illness, who may also have challenging behaviour or are on a supervision register. The objective is to enable people to reach their optimum level of independance. The statement of purpose says that there are staff on duty twenty four hours a day. Placements at the home cost between 700 to 980 pounds. Residents are expected to pay seperately for some items including cigarettes and magazines, holidays and clothing. Following Inspecting for Better Lives, the provider must make information available about the service, including inspection reports, to residents and other stakeholders. Care Homes for Adults (18-65 years) Page 5 of 26 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: This inspection took place over one day. Throughout the inspection, the Registered Manager and Deputy Manager assisted us and described the philopsophy and running of the home at length. We spoke to two people living in the home and toured the building and grounds.We saw the care records of all five residents, seven staff files and training records, and other general homes records. The home also provide a good quality Annual Quality Assurance Assessment which informed this inspection. Care Homes for Adults (18-65 years) Page 6 of 26 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 7 of 26 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 8 of 26 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. Prospective residents can be assured that they will have their needs thoroughly assessed and they will have opportunities decide, with support, if the service is right for them.The home ensures that it is able to meet peoples needs appropriately, prior to people moving in. Evidence: The home registered as a new service with five beds in August 2009. Ashness House was previously registered with four beds and the main change since the new registration has been improvement and expansion of the physical environment, additional capacity and one additional person moving into the home. The home was newly registered to ensure that it is correctly registered as a limited company. We saw the files of all five people living in the home. Thorough needs assessments had been completed prior to each new person moving in and residents had had the opportunity to make trial visits and get to know the home beforehand. Alongside the homes own assessments, there were detailed assesssments on file from Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: mental health and other professionals. Annual reviews had been done by the placing authorities and there were regular mental health reviews and formal reviews by the home. It was clear from the files and from talking to staff and residents that initial and ongoing assessment was an integral part of the homes way of working with residents. We discussed the needs of the people with living in the home with the Registered Manager and Assistant Manager. Residents have complex mental health, social, emotional and, in some cases, physical needs. Some residents have a forensic mental health background and most have dual diagnosis mental health and alcohol and drug histories. Relatives that are involved with the residents have the opportunity to participate in the care assessment process. There was clear evidence that peoples complex needs had been fully understood by the home before the residents moved in. This enabled the home to plan appropriately to meet these needs. Staff we spoke to had an in depth understanding of each person and were able to describe how they assessed and met their needs. We observed staff interacting sensitively and knowledgeably with the residents. The home has a clear statement of purpose and service user guide which provide good information about the service for potential residents, their families and referrers. Care Homes for Adults (18-65 years) Page 10 of 26 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. Residents are supported to make their own choices and live the lives they wish to. Their care plans cover all aspects of their lives and are regularly updated to reflect the residents changing needs and wishes. Evidence: We saw the care files and plans of all five residents and discussed them with the Registered Manager and Assistant Manager. Residents have comprehensive care plans and risk assessments in place. The care plans were clearly arranged to cover the main areas of each persons needs. They contained full assessments, reviews, information on appointments and correspondence. Regular reviews had been completed by mental health professionals, social workers, care managers and other professionals. The care plans and risk assessments were updated to a very good standard. The files and care plans also contained good information and guidance on peoples cultural backgrounds and needs. The home has a keyworker system in place and the Assistant Manager gave a good Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: description of how keyworkers support the resident. This was confirmed by the residents we spoke to. Each person had detailed risk assessments, which had been regularly reviewed and updated to reflect any new risks to their wellbeing. These assessments demonstrated how the risks could be managed without constraining each residents life unnecessarily. The risk assessments gave good guidance to staff, with details of behavioural early warning signs and ways to support the residents. Residents interests and choices of how they spend their time were clearly outlined and the residents we spoke told that they were able to live their lives inside and outside the home in ways they wished to. Residents need varying degrees of support to manage their finances and the home has good systems in place to protect the residents. These were also thoroguhly reviewed and improved after a safeguarding issue in this area. Throughout the inspection, we observed positive and constructive interactions between the staff and the residents. The residents appeared very comfortable and confident with the staff and able to express their wishes and needs. Staff were observed to be sensitive and responsive. The daily life of the home appeared relaxed and residents were clearly spending time as they wished and coming and going throughout the day. Care Homes for Adults (18-65 years) Page 12 of 26 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. Residents are supported to develop their daily living skills and follow their own routines.This includes supporting them with their preferred degree of family and social contact. The home enables residents to use their time as they wish and provides them with excellant choices of food. Evidence: Throughout the inspection, we saw good evidence that the residents are encouraged to develop as individuals and improve their independence and wellbeing. There was evidence on file and from what people told us of residents degrees of wellbeing and independance improving significantly over time. Residents spend time at home, in their rooms or communal spaces. We spoke to one Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: resident in his room, which he had recently moved into. He told us that he really liked the new room, which was highly personalised and ensuite. He also said that he was enjoying learning to cook for the first time and was able to do things he thought he would not be able to do. Most residents go out into the community independantly. Activites include visits to local cafes and pool hall, going to community courses and going shopping. One resident also enjoys going to see Arsenal football team play. Residents had an annual holiday in Dorset in a caravan park this year. They were able to go swimming, on coastal walks and steam train trips. The Registered Manager told us that the residents maintain varying degrees of family contact and that the home works closely with families where they are able to. Residents choices are clearly documented in the care plans. Other choices are supported by the home, for example, their preferences around food, music, cultural and religeous observance and day to day activities. Food choices appeared to be flexible, to meet the residents wishes. There was plenty of good quality food in the kitchen. Residents cook or help with cooking and food shopping. Poeples food preferences were recorded. Care Homes for Adults (18-65 years) Page 14 of 26 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. Residents have their dignity and privacy respected. They are provided with excellant support with their healthcare needs and their wellbeing is protected. Residents are protected by safe systems for the storage and administration of medication and staff trained to use these systems safely. Evidence: All the care plans we saw indicated that staff support residents as needed with personal care. This mainly involved supporting residents to improve and maintain good hygiene, as part of a rehabilitative approach. Appropriate permissions were agreed and signed off.Staff were observed interacting sensitively with the residents, ensuring that their privacy and dignity were protected. We checked all the residents healthcare records on file. They had had regular health checkups, including input from opticians, dentists, mental health specialists and their doctors. Healthcare records were kept up to date. The residents have had their mental health needs regularly reviewed by appropriate professionals. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: Residents healthcare needs that require regular monitoring include epilepsy, heart condition, the effects of Kosokoffs Syndrome and stomach ulcers. One residents bedroom is on the ground floor because they have physical mobility needs. All residents have had their weight monitored regularly. Several residents have had issues with weight and the home works with a dietician where necessary. The home supports residents to maintain regular eating habits as part of their rehabilitation. The Deputy Manager showed us the medication arrangements. The home uses a blister pack system and has a contract with Boots Chemist. Medication is stored in a locked cupboard in the office. The medication administration records we saw were accurate and reflected good practice in the home. They were appropriately signed by trained staff (confirmed by the training records). The Deputy Manager showed us how medication is delivered to the home and returned to the pharmacy, with a clear and systematic audit trail. Medication administration records were signed appropriately by staff. There is clear written guidance for staff on PRN (as required) administration. One resident who self medicates had a risk assessment in place to cover this arrangement. Care Homes for Adults (18-65 years) Page 16 of 26 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 supported to raise their concerns and know how to do so. They are protected by staff trained in safeguarding and who know how to follow the homes safeguarding policies and procedures. Evidence: We observed that the residents appeared comfortable to express their wishes and concerns to staff as they arose. Both residents we spoke to told us that they knew how to express any concerns they had. The home has a clear and accessible complaints policy and procedure. We saw the complaints records. No complaints had been received but we are confident from the homes way of working that any complaints would be thoroughly investigated and addressed. The home has a close relationship with the London Borough of Haringey and the Registered Manager and staff had a clear understanding of safeguarding adults and the local authority safeguarding policies and procedures. Staff understood what to do if there was a safeguarding concern. The training records showed that they had been trained in safeguarding adults. The home had had one safeguarding issue in the past year. This was appropriately Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: addressed, the local authority and Care Quality Commission informed, procedures followed and comprehensive steps taken to remedy the issue when it was found to be upheld. Care Homes for Adults (18-65 years) Page 18 of 26 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. Residents live in a very comfortable, homely environment, which is regularly maintained and improved to meet their needs. The home is kept safe, well maintained, clean and hygienic Evidence: The home is in a terraced house in Tottenham. It appeared safe, clean and comfortable. There are local shops close by and good access to public transport. The home has increased its bedroom numbers since the last inspection under its old registration. It now has five ensuite bedrooms and can accomodate five people. The organisation has done considerable improvement work on the house. This has included new flooring, painting and new decoration and refurbishment of the bedrooms and lounge. Residents and staff keep the home clean and there is a good quality washing machine. There was evidence of a good practice in infection control and guidelines for staff. Staff have been trained in infection control. Care Homes for Adults (18-65 years) Page 19 of 26 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 protected and enabled by a safely recruited staff team who are comprehensively inducted, trained and supported. Evidence: We looked at the files of seven staff and all the training and supervision records. All staff have been safely recruited, with thorough preemployment checks carried out. These included obtaining two written references and a current Criminal Records Bureau and POVA check before they commence work. The staff member we spoke to had been recruited and was able to confirm that these checks had been properly undertaken before they started working in the home. All staff have a recent photograph on their files, along with contracts, preempployment health checks, job descriptions and evidence of the right to work in the UK. We discussed with the Registered Manager how the home checks gaps in peoples employment history and what he does if a prospective staff member has a criminal record. The current application form needs to be updated to cover this and a requirement is given. The induction process is very comprehensive and well documented. Staff undertake an Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: induction over several weeks and sign off when they have familiarised themselves with specific policies and procedures. The Registered Manager and Assistant Manager described the shadowing process, in which new staff work alongside existing staff to get to know the residents and ways of working with them. Staff training certificates are kept on file. The Registered Manager told us about the training programme followed by the home, which is comprehensive and reflects a considerable investment. This is divided into internal and external training and covered all mandatory training in a rolling programme. The home has good access to Haringey Councils free training programme and there were certificates on files for the courses that the staff have attended. Training also includes funding the Assistant Manager through a degree in Psychotherapy, mental health awareness, cognitive behavioural therapy, counselling skills, challenging behaviour and risk management, equality and diversity and care planning. Staff are also supported to complete NVQ qualifications in care. We saw the staff rota, which indicated that there were sufficient staff on duty to cover the needs of the residents. We saw the supervision records. All staff had received individual supervision from Registered Manager or Assistant Manager at least every six weeks. Supervision notes were good and indicated that there is a focus on meeting the residents needs and staff professional development. Regular staff and management meetings are held and the minutes clearly demonstrated that residents needs and interests were discussed, along with the running of the home. Both supervision and management meeting notes had detailed action plans with responsiblities and timescales. Staff have had regular appraisals and action plans developed from them. Care Homes for Adults (18-65 years) Page 21 of 26 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. Residents live in a well run home with excellant management. They are protected by the homes quality assurance and health and safety policies and procedures. Evidence: The Registered Manager runs this service and another local home, Ashness Two. He has a Registered Managers Award and extensive qualifications in mental health and management. He demonstrated an excellant understanding of the residents needs and worked sensitively with them. Residents appeared comfortable and confident with him. He clearly worked openly, closely and transparently with the residents and staff. The home has recently newly registered. This was resolved an anomaly where the home needed to be registered correctly as a limited company. The home has good policies and policies in place. These policies have clearly been developed specifically to meet the homes needs and not bought off the shelf, as is sometimes the case. The organisation is still developing a formal quality assurance system. The Registered Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Manager described the quality assurance mechanisms he has put in place and how he acts on the feedback received to improve services. He gave clear examples of how this has been done.These include regular residents meetings and discussions with residents. Regular health and safety checks have been completed and we looked at the certificates kept at the home. These were all up to date and in order. The home has up to date Public Liability Insurance. Fire safety checks are done regularly and fire drills done. The home has a fire risk assessment and this is regularly reviewed. The home had compliance visit from the local officer in October 2009. We also saw records of weekly alarms tests and the maintenance checks on the fire safety equipment. Staff are trained in health and safety,food hygiene, first aid and infection control. Incidents are clearly recorded in care files. Actions in response to incidents and accidents are taken by staff and each persons file, care plans and risk assessments are updated as necessary. The home reports serious incidents to the Care Quality Commission as required under Regulation Thirty Seven of the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 32 18 The Registered Person must ensure that there is a good system in place for checking gaps in employment by for prospective staff. Thorough pre employment checks must be carried out to protect the residents. 31/03/2010 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 Care Homes for Adults (18-65 years) Page 25 of 26 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. 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