Care Home: Bramley Avenue (73)

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What the care home does well Comments from relatives included " The staff are always helpful when I call to visit and always let me know if my cousin has any problems" and " I think the service supports my (relative) very well-she is healthier and happier than she has ever been". Staff are very person focused and the records they complete are clear and well written. The manager and staff are always thinking ahead of ways to improve the lives of those they care for. What has improved since the last inspection? New person centered planning has been introduced and will make a significant difference to people`s lives. There is a new kitchen with areas accessible to wheelchair users, which means people who live in Bramley Avenue can participate in different activities. What the care home could do better: There are no areas of concern as a result of this inspection. We are aware that the manager is pro-active in making any improvements she and her staff feel are necessary to enhance the lives of those who live in Bramley Avenue. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bramley Avenue (73) Bramley Avenue (73) Melbourn, Near Royston Cambridgeshire SG8 6HG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Hilton     Date: 0 7 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Bramley Avenue (73) Bramley Avenue (73) Melbourn, Near Royston Cambridgeshire SG8 6HG 01763261682 01763228116 Bramley@grantahousing.org.uk www.grantahousing.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Granta Housing Society Limited care home 5 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 5 The registered person may provide the following categories 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: Learning Disability - Code LD, Physical Disability - Code PD Date of last inspection Brief description of the care home Bramley Avenue is home for up to five adults who have a physical and learning disability. The home is a purpose built bungalow with five single bedrooms, separate kitchen (which has been replaced since the last inspection) / dining room, living room containing multi sensory equipment. There is a large, fully enclosed sensory garden, designed to be wheelchair accessible, which has a large fishpond, patio and barbeque 5 5 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home area incorporated. There is a new summer house, which staff intend to use as an activities area when the weather improves. The bungalow is situated in the village of Melbourn, close to local amenities. It is in a no through road, and there is sufficient parking outside. There are good links to the City of Cambridge, which is twelve miles away, and Royston, four miles away. The home has two minibuses to enable people who live there to have trips out and attend appointments. Twenty-four hour care and support is provided by Granta Housing LTD. Care staff provide a comprehensive package of care including day care activities. Increased staffing levels are provided when specific activities are offered, such as swimming. There are no staff vacancies in the home and more staff have been reciruited to work as bank staff. The manager still uses some agency staff to cover when necessary. The agency staff supplied know the home and work there regularly. The placing authorities arrange the contribution to be made by those living in Bramley Avenue. Copies of the inspection reports are in the office at the home. Care Homes for Adults (18-65 years) Page 5 of 27 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: We, the Care Quality Commission (CQC), carried out a key unannounced inspection of Bramley Avenue on Tuesday 7th July 2009 at 07:20hrs, using the Commissions methodology described below. This report makes judgements about the service based on the evidence we have gathered. Staff (including night staff) and the manager were spoken to. An Annual Quality Assurance Assessment (AQAA) was completed and returned to the Commission prior to this inspection. This provides us with some statistical data as well as the views of the manager as to the quality of the service being provided to those who live there. Surveys were sent to the relatives of those who live there and to staff. Two relatives surveys and six staff surveys were returned. Information they provided will be in the body of the report. Care Homes for Adults (18-65 years) Page 6 of 27 A number of records were seen together with two staff files and one file of a person living in the home ( as well as elements from the files of other people). There were five people living in the home on the day of inspection with no vacancies. The manager was present for most of the inspection. The last key inspection took place on 15th August 2006. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 27 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 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information provided and visits and stays at the home allow people to decide if their needs can be met there. Evidence: Copies of the Statement of Purpose and service user guide are available in the home, and have been updated. The documents continue to be specific to the resident group, considering the different needs, support and treatment of each person. The information is provided in suitable language and pictures. The level of physical and learning difficulties of each person in the home means that the methods of providing information are individual. Staff use their experience and knowledge of the person to ensure, as far as practicable, that they have the information they need. The most recent admission to the home was made just after the last inspection in August 2006. Comments were made in that report about the time and effort made to ensure the person had visits and stays before the possible admission to reside in the home; as well as recording each visit, what had taken place and the effect on the prospective resident and those already living in the home. A comprehensive needs Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: assessment was made and a multi-disciplinary team involved in the decision because there were no family members known at that time. The assessment focuses on achieving positive outcomes for the person Details in the AQAA showed the admission in August 2006 had been very positive and staff would ensure the same methods of introduction were used. Policies and guidelines have continued to be developed in the home, with the involvement as a far as possible of people living there. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured of excellent care because of the detailed care and support plans. Evidence: The key principals of the home for delivering a quality service continue to be based on the belief that people who live there should take control of their own lives. The staff are still committed to supporting people to make choices and decisions (including the right to take assessed risks) to enhance their lives. Deatils in the AQAA showed that individualised budgets are being looked into for people living in the home and a representative from Mencap is involved. Details in the AQAA showed that person centred planning (PCP) is being promoted in the home. The care and support plans are very detailed and focussed on the individual; but staff are now taking this further and using a variety of methods involving people living in the home even more than they were. The level of interaction Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: and communication is different for each person living in the home so staff have to use pictures, memory boxes and sensory items, for example, to build a comprehensive personalised plan. One was seen during the inspection and photos had been used to show the interaction between the staff and person and the methods they had used to get information. The person centred plan was just that, very personal, and included the people involved with the person, likes and dislikes in many areas including activities and food and how they would be incorporated in the day to day life of that person. Care and support plans seen during the inspection continue to provide excellent detail and would allow anyone to understand the needs of the person and how these needs are met. People have a key worker who is closely involved with their care and support plans and who ensures they are reviewed regularly. Since there are only five people living in the home staff are aware of all their needs and how they are met. Staff spoken to on the day of inspection demonstrated their understanding and knowledge of each person living in the home. The staff are pro-active at involving advocacy services such as Speaking Up and the Independent Mental Capacity Advocates (IMCAs) with some of the people living in the home and there was evidence of this on files. Comments in the staff surveys included Although we have an activities programme, we have to be flexible and change according to their (the residents) needs; the home focuses on respect and communication. Lots of activities and opportunities to do things and meet people. We are carrying out person centred planning; we work hard to promote independence. We give service users opportunities. We respect individuals needs and maintain good environmental stimulation. Care Homes for Adults (18-65 years) Page 13 of 27 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 in the home have the opportunity to take part in appropriate activities which they enjoy. Evidence: People living in the home have a very varied and stimulating lifestyle. There are activties within the home as well as many more outside. These include visits to family, going to concerts, walks by the river, hairdressers, shopping trips, swimming, posting letters, local pubs and the library. In the home they have theme nights such as Italian, cowboys and indians; cooking, salvation army service, visits from beautician and the homes garden (growing vegetables or sitting in it). Lots of photos are taken when activities take place and they are around the home, in peoples rooms and in an electronic photo holder that changes the picture every few minutes. Activities are noted and the enjoyment of the person and their reaction is detailed so staff know if an activity is a positive experience. This can only be done because staff have a Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: complete understanding of the different ways people communicate their emotions. This was evidenced during the inspection when people were offered choices and also detailed in the care and support plans. The manager said she was waiting for two new minibuses to arrive so more trips could be planned. She stated that most staff could drive the transport so there were no problems for people getting out into the community. As a result of completing the personal care plans it was found that one person would like to go on a train journey, meet with her friends, listen to and be involved in music, and go to the library. Some are already part of her life but others such as the train journey will be planned. The manager said that staff work until 11pm on days that some activities occur (such as concerts) so people who live in the home can stay for the whole time. The AQAA showed that each day every person has a My Day sheet completed. This includes what has been important to that person that day as well as who assisted them to get up, eat, what was eaten etc. One person has a pureed diet and the way she was assisted to eat at the mealtime was dignified and caring. Some of those living in the home are fed through tubes, but are still made to feel part of the group as they sit in the kitchen or by the table at mealtimes. The tubes are now much more discreet and the food is held in a backpack style pack which is much less obvious and means people can go out into the community with dignity. Comments in the staff surveys included the home is just that. The needs of the residents are put first; we ensure the service users needs are met to the best of our knowledge; treat residents as individuals. Make sure residents are put first. Care Homes for Adults (18-65 years) Page 15 of 27 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. Health and personal care needs are identified for each person and relevant professionals involved to meet those needs, to ensure their wellbeing. Evidence: Deatils in the AQAA showed that the care and support plans include a variety of information including photographs, pictures and text to cover all areas of support needed such as communication, personal care, nutrition, enteral feeding, night support and mobility. This was evidenced in the files seen during the inspection. There were specific areas where more information had been provided such as photos to show how to seat the person before feeding, information on a chronic disease, which gives staff a very clear understanding of the problems. The medication administration record (MAR) sheets were checked and all found to be completed. There was a list at the front of the file to show peoples signatures and the initials they put on the mar sheets. There were also details of the specific medication a person was taking, why and their preferred method of adminstration. Boots had recently completed a medication inspection and there were no major issues. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Staff were seen and heard to respond appropriately to people, treat people with respect and knock on doors before entering. Personal care was completed in private, with full details of what was required on care and support plans. The details on the My Day record shows when people had a bath/shower and who gave it. There was evidence on files of the involvement of GPs, District nurse, dietician, dentist, optician, occupational therapist, speech and language therapist, epilepsy nurse, palliative care team and psychologists. As part of the recording on My Day each person has an area where any special and specific information needed is written, this is incorporated in to the form. For example one person needs the times when her pain relief is wearing off recorded, and another person how and what she eats.The manager said that one person requires pain relief and the palliative care team are fully involved. Staff can tell when she is in pain and can increase the frequency of doses if required. This was evident on the day of inspection. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The whistleblowing and safeguarding procedure in the home protects people who live there from abuse. Evidence: Bramley Avenue has a complaints procedure that contains all the necessary information clearly written so that relatives, professionals or others can make a complaint. There are details provided in each persons room together with an envelope so that people do not have to speak to staff or the manager if they do not wish to. The Manager nor the Commission has received any complaints or concerns. There are policies and procedures in place regarding the safeguarding of people living in the home. There has been one safeguarding issue that has been dealt with appropriately by the manager. Care Homes for Adults (18-65 years) Page 18 of 27 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 home and grounds are accessible for those living there and are well maintained to provide a pleasant homely environment. Evidence: Bramley Avenue is homely, clean, safe and comfortable and meets the needs of people living there. There has been a new kitchen installed since the last inspection and this has facilities at the correct height so that people living in the home can participate in some cooking and water activities. The office is also the staff sleep in room and there are small additions to try to make it acceptable as both eg pot plants and nice blinds. There were no unpleasant odours anywhere in the home. People have very personalised bedrooms with the colours they like, special lights, hanging decorations, pets such as gerbils, photos and pictures. There is a tank of fish in the living room, sensory equipment, a water bed, fibre optics, bubble tubes, large flat screen TV, new heating system and on the day of inspection work was taking place to put in an extractor fan. The corridors are gaily decorated and Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: have lots of photos and painted scenes on them. One person loves football and outside his room there is a huge mural of a match. A lady in the room next door has retaliated good humourdly by having a mural of pink flowers and a garden scene outside hers. The gardens are maturing and people are encouraged to spend time out there (when the weather permits) and plant vegetables or just instruct staff on doing it. There is a new summer house that the manager said would be utilised as an activities area in the future and is useful extra communal space. The garden is home to a rabbit (who was away on the day of inspection) that people in the home help look after and can hold. Staff surveys showed that Service users rooms are decorated to their individual taste. The environment is clean fresh and homely, a very nice place to live and work in; we provide an excellent environment for the service users to live in; Lovely environment-homely, clean and personal; the home is maintained very well. Its clean, the interior is nice and comfortable. Care Homes for Adults (18-65 years) Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have a competent, qualified and professional staff group to meet their needs. Evidence: The recrutment process is good and the needs of people living in the home are at the centre of this. Two staff files were seen and they included all the necessary information. One person had been requested to provide more details of dates of employment and these had been looked at by the manager. No staff start work at Bramley Avenue before the full Criminal Record Bureau (CRB) check has been completed and is satisfactory. The files are well organised and easy to read. Night staff wre spoken to before they went off duty. Both the waking and sleeping night were agency staff but one only works at Bramley Avenue and the other is a regular at the home. They said they had completed an induction, had read the detailed files on people living in the home and had shifts where they were supernummerary before working with people independently. Both were confident in the care they needed to provide overnight and completed the necessary records before going off duty. Bramley Avenue uses the Skills for Care common induction together with the Learning Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Disability Qualification workbook. There was feedback from the staff member about the induction. There is training provided by Boots on medication. The manager is setting up competency files where staff have to complete questionnaires on areas such as food hygiene, medication, eteral feeding, health and safety and document signing. Some have started to complete them and they are then looked at by the manager and further training will be given if necessary. The manager has completed the two day Safeguarding Adults course and all staff will complete the one day course with a yearly refresher. The rota was seen and the staff rotad to be working were on site. Staff were very relaxed but professional in the way they dealt with people in the home. They were polite and caring. One staff member had recently been promoted and there were deatils of what that role entailed. Staff confirmed they received supervision and there was evidence on file. Appraisals are also completed annually as well as other checks. There were minutes from a staff meeting that had taken place on 10/6/09 and another meeting was due the day after the inspection. Staff comments in the surveys under what the home does well, included We provide the service users with a very good care service; training, relevant information, communication, carer progression; Good team work. Good working practices; installs core values. Care Homes for Adults (18-65 years) Page 22 of 27 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. The leadership and management of the home ensures the safety and welfare of people living and working there. Evidence: The manager has the necssary qualifications and experience to run the home. She continues to work to improve the service provided to those living and working there. Staff said the manager was very good and provided any support necessary. The manager has a person centred approach to care, which was evident in files and on talking to staff and observing people who live there. She supports a strong and very caring staff team who are knowledgable and very focussed on the needs of the people they are caring for. It was clear on the day of inspection that the home is run round the lives of those who live there and not staff needs. Information provided in the AQAA showed that the home has the necssary policies and procedures in place, and these are reviewed regularly. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: There is a yearly quality assurance review through Quartz completed and the report for last year was seen on the computer. This provided the manager with an overview of the service provided and there were no areas of concern. Comments made in the staff surveys included We have a manager who is very competent in her role. Very good at acknowledging the needs of the residents and supporting the staff to carry out their role, Good working practices; the project manager is very supportive and professional; maintains high standards. Care Homes for Adults (18-65 years) Page 24 of 27 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 27 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 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 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!