Care Home: Bedfordshire Cheshire Home

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What the care home does well Areas that the service does well includes: Making sure that all the people who use the service are made aware of their rights. Staff have a very clear vision on how people have the right to privacy, dignity and respect and a contract is made with each person who decides to move into the home explaining how staff will treat them. The homes resident committee is also very good at making sure people have their say in how the home is run and residents said that they felt that they are listened to and the home does act upon their views. The systems in place to ensure health needs are met are also very good. People at the home continue to have a key worker of their choice if they want one, and that person assists them in accessing health care support when needed. Everyone we spoke with commented on feeling that they received the health care support that they needed, to keep as healthy as possible and to live as independently as possible. Physiotherapy is provided within the home as well as outside, with regular clinics being held for those that need them. People living at the home continue to be involved with how it is run. They have meetings and decide about things like activities and trips out, and what should be on the menu. Lots of meetings were held about the recent building work that has just been completed and people had chosen decoration schemes and colours for their rooms. The way that medication is managed in the home is also good. One person is responsible for ordering medication and making sure audits are carried out. We looked at medication records, stocks and administration and found that medication was being given how it should be. What has improved since the last inspection? At the last key inspection we did not make any requirements. However a re refurbishment of the home has now been completed. Many of the areas now have wider access through doorways, automatic on lighting and additional equipment in place to assist the people living at the home. One person said, "I think it is wonderful the changes they have made, its helped me in many ways, just getting around is easier". What the care home could do better: An acting manager was in post at this inspection. An application must be submitted to us for a manager to be registered. It is acknowledged that temporary contracts were in place whilst the previous Registered Manager was on secondment to another post, however the owners of the service must be clear on how they are to progress with the management at the home. Documents in the home including care plans need to be improved upon. These documents are important as they record the current well being of a person, and when completed in full quickly identify any changes that are taking place and indicate actions that staff must make. Key inspection report Care homes for adults (18-65 years) Name: Address: Bedfordshire Cheshire Home Agate House Woburn Road Ampthill Bedfordshire MK45 2HX     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: Katrina Derbyshire     Date: 0 6 0 4 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Bedfordshire Cheshire Home Agate House Woburn Road Ampthill Bedfordshire MK45 2HX 01525403247 01525840244 agate@lc-uk.org www.lcdisability.org Leonard Cheshire Disability Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elizabeth Turton Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: Specialist Care for Severe Physical disabilities, for 12 persons. The home is permitted to accommodate up to and including 3 people who are 65 years of age and over within the category of Physical Disabilities (PD). The purpose of this condition is so that the home can continue to care for people when they reach their 65th birthday. Date of last inspection Brief description of the care home Bedfordshire Cheshire Home is a purpose built single storey home for service users with a physical disability. All the rooms are for single occupancy . All the rooms have a small-designated garden/patio area. The home is split into four areas that all have their own communal lounge/dining, kitchen, bathroom and toilet facilities. In addition, the home has various other rooms Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 36 Brief description of the care home for recreation, activities and therapeutic interventions. The home is situated on the outskirts of Ampthill with good road links to local towns and the motorway. The home has attractive grounds and ample parking. The home also has transport available for accessing community services and leisure facilities. The home is part of the Leonard Cheshire Foundation. Major refurbishment works have just been completed. Further information about this home can be obtained by contacting the home direct by telephone or email, or by visiting. 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: The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This was an unannounced key inspection carried out on the 6th April 2010. The care of three people was looked at in detail and this is known as case tracking. Tracking peoples care is the methodology we use to assess whether people who use social care services are receiving good quality care that meets their individual needs. Prior to the visit taking place the Care Quality Commission had sent to the home an Annual Quality Assurance Assessment (AQAA). This was returned prior to the visit and provided information on how the service self assess their own performance. In addition we received 7 surveys from people who lived at the home and 4 staff, these gave their views on the home and have been used as part of this inspection. Care Homes for Adults (18-65 years) Page 6 of 26 The focus of this inspection was to look at the key standards. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: An acting manager was in post at this inspection. An application must be submitted to us for a manager to be registered. It is acknowledged that temporary contracts were in place whilst the previous Registered Manager was on secondment to another post, however the owners of the service must be clear on how they are to progress with the management at the home. Documents in the home including care plans need to be improved upon. These documents are important as they record the current well being of a person, and when completed in full quickly identify any changes that are taking place and indicate actions that staff must make. Care Homes for Adults (18-65 years) Page 8 of 26 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 9 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 10 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. The standard of assessments carried out before someone moves into the home are good,so people living at the home can be sure that their needs and aspirations will be met. Evidence: As assessed previously prospective residents are sent a pack with lots of useful information including a current newsletter, and a brochure. Members of the multidisciplinary teams are asked to complete full assessment reports regarding any resident who wishes to move into the home. The Acting manager also visits the person, and their carer if the person wishes, to complete a full assessment of needs and aspirations to make sure that the home would be the right place for them. Visits and overnight stays can be arranged and the whole process is managed in a very individual and personal way. A full assessment had been completed for a resident receiving respite care. Contracts are issued and signed by each resident. The contracts identify fee rates and services included for that fee. Care Homes for Adults (18-65 years) Page 11 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. People at the home are helped to live as independently as possible, and residents can do the things they want to. Therefore people living at the home know that their changing needs will be met.However care documentation needs to improve to ensure up to date information is available. Evidence: Risk assessments were seen within the care records of the residents. Risk assessments had been carried out in the following areas, nutrition, falls, moving and handling in addition personal safety had also been covered. Risk assessments were noted to identify individual risks to residents and then guidance was given to staff on the support that they should provide to reduce that identified risk to the resident. Risk assessments had now been reviewed in a timely manner so changes in personal circumstances of the residents had now been taken into account and the risk assessments adjusted accordingly. Staff confirmed that they had responsibility for ensuring that all these records were kept up to date. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Residents at the home help with the development of their Individual Service Plan, when they first move in, and at subsequent reviews. If the resident wishes, family members are also involved. The acting manager and staff help residents to explore opportunities available to them, and they explain peoples right to take risks when living at the home. However in the four months prior to this visit care plans had not been kept up to date. Changes in a persons circumstances had changed but records had not been updated to reflect this. The acting manager advised that she had identified this and had already raised it at the last staff meeting. Everyone spoken with indicated that they make choices all the time about their lifestyle, and that the opportunities available to them are viewed very positively. They all knew about the key worker system and were able to name their key worker. The homes annual survey gave positive results regarding peoples ability to make decisions and have control over their lives. For example residents are able to control their money with support if necessary, and choose decor and furnishings. Several people wish to leave the home without staff, plans are in place for this and it is acknowledged that people will take risks, and uneasy restrictions are not put in place just because they are a resident at the home. The home is continuing to develop more of its information in different formats and most of its records are in picture format. The home invites residents to participate in the running of the home through meetings and in other informal ways. This is long standing practise, people spoken with confirmed that they continue to have a say in how the home is run. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are able to take part in activities of their choosing, to help meet their needs in this area. Evidence: Several residents commented on the standard of food provided at the home, all residents felt that it was of a good standard and they believed that they had a wide variety of options and choice available to them. Menus in the home showed that nutritionally balanced meals were provided that included fruit and vegetables. Some residents required a prescribed nutritional supplement to meet their dietary needs, of those examined it was noted that the correct dosage and method of administration was in use, and clear guidance was in place to qualified nursing staff on the required regime. Residents spoken to were very clear on their own rights and responsibilities whilst Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: living in the home. All commented on the information available to them when they moved into the home and this was supported by a comprehensive document that was made available to all residents. Residents were aware of how they should be treated, that they still had the right to be treated as any citizen would and where they could go if they believed that their treatment was not acceptable. Residents can attend college if they wish, and in the new activities/craft room computers are available and in their own rooms. A large range of activities is provided in the home in a well organised and structured way. Residents are able to go to pubs and shops in Ampthill, although wheelchair access is sometimes difficult. Several of the residents have previously led local campaigns to improve pathways in the locality for example. The home has the use of vehicles for transport.The links with the community continue, on the day of this inspection 2 volunteers were in the home. Relatives visiting on the day of inspection confirmed that family members and friends are made very welcome at the home at any time. They are welcome to accompany residents on trips out. Meetings with residents are held, and 3 residents confirmed that these are productive events. Lots of matters are discussed including agreeing the schedule for activities and trips out. Minutes are taken at meetings, and a newsletter is produced. Care Homes for Adults (18-65 years) Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support is offered in the home in such a way to protect and promote residents privacy and independence. Medication systems are managed well and there is excellent access to health care support. Evidence: Observations of care practise were made throughout the inspection in varying areas of the home. On all occasions staff were noted to approach residents in a respectful manner and address them in a way chosen by that resident. Protective clothing was used when necessary in the provision of personal care to maintain hygiene standards alongside necessary equipment for the safety and comfort of the resident. Residents spoke of choosing their own clothing, hairstyle and personal items and confirmed that staff assisted them in doing so. Staff and records confirmed that a Doctor or Specialist Nurse had been called when someone needed medical support. One example was a person had presented with Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: increased confusion and their appetite had decreased over two days, staff called a Doctor who following their visit prescribed antibiotics, and the persons health then improved. The storage, receipt and administration of medication was examined. The medication administration sheets were noted to be correct. On counting a sample number of medications, all balances were noted to be correct. Staff confirmed that they did receive regular updates in the administration of medicines and certification of training was seen in staff files and observations were made of medication and noted to be appropriate and follow safe practise guidelines. Several of the people living at the home had complex care needs.They required extensive physiotherapy, specialist equipment and additional health care support. Through the reading of documents, speaking to people who use the service, and staff it was noted that all these needs were being met. Care Homes for Adults (18-65 years) Page 17 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. The staffs level of knowledge and understanding of Adult safeguarding issues is good and this assists in protecting the residents from abuse. Evidence: The home had a clear policy that provided guidance and instructions to staff in protecting adults. The policy included types of abuse and these included physical, emotional and social examples. Staff and their training records confirmed that they had also received training in this area. On questioning staff they were able to accurately report to whom they would report any alleged abuse and how this reporting would be carried out, this matched the guidance contained within the local safeguarding policy. People spoken with confirmed that they felt happy to raise any concerns that they had, this would be either direct to staff or through a residents meeting. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accessibility of facilities in the home are excellent and ensure residents can remain as independent as possible. Evidence: The planned refurbishment programme described at the last key inspection was now completed.Several changes have taken place and include a smaller physiotherapy room and smaller activity suite, also the shop and bar has been lost due to the space being used for other things. However benefits include, smaller group living, larger bedrooms, the addition of en-suites, and improved wheelchair accessibility among other changes. In addition in many areas there is now automatic on lighting, computer sockets being available in each bedroom, kitchen facilities that are accessible for residents and full re decoration and new furnishings in all the areas of the home. Everyone spoken to commented on how pleased they were with the changes. One person said, I always said the care was excellent, now the building is too. Areas were noted to be clean and tidy throughout. Domestic and maintenance staff are employed at the home, in addition clinical waste contracts are in place. 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. Positive relationships between staff and residents mean people feel comfortable and secure in the knowledge that staff will be able to meet their needs. Evidence: Observation at this inspection showed staff to be attentive and professional in their manner when dealing and communicating with residents and others. When questioned they were able to describe residents individual and detailed needs, and they were clear about their role in the organisation. They had received training. Residents and family members indicated that relationships with staff are very positive indeed. They knew the name and role of their individual key workers, and reported that someone is employed to deal with all of their needs. Training is planned through the company and guidance is followed at home level. Documents examined showed that staff had received training in the areas that they needed to and included safeguarding and fire training. The acting manager advised that it is her plan to hold various workshops in the home in 2010, these would be on specific areas including multiple sclerosis and wound care. Staff meetings had been held in the month prior to this inspection. The acting manager advised us that she had used these to communicate that the service needed Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: to improve. She reported with the refurbishment and change in management that records had not been given priority. However the staff meetings had been used to highlight to staff the direction the service now needed to take. Examination of staff records to look at recruitment practises was undertaken. Staff had completed an application form and safety checks had been carried out prior to them starting work in the home. However one staff file for a nurse did not have the up to date pin check in place, and this was being secured by the acting manager. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and safety is managed sufficiently to reduce risks in this area for people living at the home. Evidence: The Registered manager of this home was promoted within the company in 2009. Due to secondment restrictions relating to the advertisement of posts, the current acting manager advised that her contract was not yet permanent. However there is a need to have a Registered manager in place and the company must act upon this. The current acting manager is a registered nurse who is experienced for the posts she was the previously the deputy manager of the service. The manager is supported by staff at the home, including help for administrative and health and safety duties, and also by senior personnel from the organisation. For example there is a training manager and a human resources adviser. The acting manager feels very well supported as the previous manager is now her line manager. The management style at the home continues to be open and inclusive. Residents Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: expect to be involved in all aspects of the running of the home, and they are. The home is run with residents needs at the heart of decision making. For example the key worker and named nurse system is well established for the benefit of residents. As previously assessed Residents have meetings which they reported are helpful, meaningful and vibrant affairs. Resident meetings to address particular issues are also held. The home was noted to have a comprehensive policy for the management of Health and Safety in the home. Fire safety was maintained through regular alarm tests and the time these were carried out were all recorded alongside safety checks of fire equipment, by a specialist contractor. Staff had all received training in a variety of Health and Safety subjects and these included food hygiene, moving and handling and infection control. Certificates or copies of certificates of attendance are maintained within the training files at the home. Residents and their representatives had been asked their opinion on the services offered by the home as part of the quality assurance system. The results and how the home acted upon the views of the residents were available for inspection. 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 37 8 There must arrangements for a manager to submit an application to become Registered. This is to ensure that a person registered under the Care Standards Act is in charge on a day to day basis. 16/07/2010 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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