Care Home: Coldwell Villa

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What the care home does well The home uses pictures and symbols to enable people to say how they would like their needs to be met, what activities they like to take part in, and places they like to visit.Service users are asked about what they would like to happen at the home. This is to ensure that their ideas and views are listened to.The home was comfortable and well maintained, and provided service users with a homely environment in which the atmosphere was pleasant.Service users were supported and encouraged to access the local community, either independently or with staff support if required.Staff were provided with a good level of training to enable them to meet the diverse needs of the service users.Staff showed patience and understanding when supporting service users through emotional difficulties. What has improved since the last inspection? All staff who provide formal supervision to junior colleagues have now received training to enable them to undertake the role.All staff now hold a National Vocational Qualification (N.V.Q) at level two or above, this complies with the requirement for at least 50% of staff employed to have an N.V.Q qualification. What the care home could do better: One requirement was made as a result of this inspection visit regarding the needs for the provider to visit the home on a Monthly basis. Other than this the home needs to continue to build upon its solid foundation of practice. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 71 Mersea Road Coldwell Villa Colchester Essex CO2 7QR The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Neal Cranmer Date: 0 8 0 5 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 32 Information about the care home Name of care home: Address: 71 Mersea Road Coldwell Villa Colchester Essex CO2 7QR 01206574588 01206574588 kp@essexautistic.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Essex Autistic Society care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: 1. The registered person may provide the following category/ies 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 2. The maximum number of service users who can be accommodated is: 5 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home The home is owned and managed by the Essex Autistic Society (EAS). The home provides accommodation and care for up to 5 adults with learning disabilities. The property is located within walking distance of Colchester town centre, pubs, a post office, public transport and other amenities. The home was opened in 1994 and is a two storey family-sized house. The accommodation is domestic in style and scale. All five bedrooms are single with each bedroom having a wash hand basin. Toilets and bathrooms are shared. A small, well maintained garden is to the rear of the property, with garden furniture and a small pond. The range of monthly fees supplied to the Commission for Social Care Inspection (CSCI) on the 22/05/07 and charged by the Society is currently between £1,035.60 and £1,201.78. There are additional charges for activities during the evenings and weekends. Individual service users meet all personal clothing, and items such as magazines and haircuts. Care Homes for Adults (18-65 years) Page 5 of 32 Holidays for service users are staffed accordingly with appropriate ratios. Staffing, transport, and food expenditure between 9.00am and 5.00pm are met by the Society. Information about the service, including inspection reports, are made available to prospective service users through a pack containing information about all of the services provided by the Society, the Statement of Purpose, a current Newsletter, and literature regarding the Societies Jigsaw Study Centre. Care Homes for Adults (18-65 years) Page 6 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 32 How we did our inspection: This is what the inspector did when they were at the care home This unannounced inspection visit was carried out on the 8th May 2009, with help from the Registered Manager and Team leader. Assistence was also provided by staff. The visit involved a tour of the home, looking at records and documents, and talking with two people who live at the home, the manager, their deputy, and three members of the care team. The Annual Quality Assurance Assessment (AQAA), is a self audit tool that the home uses to tell us what they do well, and to identify areas in which they can improve). It was well completed and assisted us in the writing of the inspection visit report. Care Homes for Adults (18-65 years) Page 8 of 32 At the end of the inspection, feedback was given to the manager and the deputy regarding the inspection visit. What the care home does well The home uses pictures and symbols to enable people to say how they would like their needs to be met, what activities they like to take part in, and places they like to visit. Service users are asked about what they would like to happen at the home. This is to ensure that their ideas and views are listened to. Care Homes for Adults (18-65 years) Page 9 of 32 The home was comfortable and well maintained, and provided service users with a homely environment in which the atmosphere was pleasant. Service users were supported and encouraged to access the local community, either independently or with staff support if required. Staff were provided with a good level of training to enable them to meet the diverse needs of the service users. Care Homes for Adults (18-65 years) Page 10 of 32 Staff showed patience and understanding when supporting service users through emotional difficulties. What has got better from the last inspection All staff who provide formal supervision to junior colleagues have now received training to enable them to undertake the role. Care Homes for Adults (18-65 years) Page 11 of 32 All staff now hold a National Vocational Qualification (N.V.Q) at level two or above, this complies with the requirement for at least 50 of staff employed to have an N.V.Q qualification. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 12 of 32 If you want to speak to the inspector please contact Neal Cranmer CPCI Capital Business Park Fulbourn Cambridge CB21 5XE 01223 771350 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 13 of 32 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 14 of 32 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 . People who may use the service and their representatives are provided with the necessary information needed to enable them to make an informed choice about the homes ability to meet their assessed needs. Evidence: The home had in place a Statement of Purpose and Service Users Guide, which was available in pictorial format to enable those people with difficulty in comprehension to have access to the document/s. Sampling of service users care plan files showed that these documents were present. Both of these documents were designed to provide information to prospective service users or their representatives about the facilities provided by the home. The Statement of Purpose was seen to provide information relating to the structure of the service, the qualifications and experience of staff, and the facilities provided. Both documents also included information regarding the homes complaints and admission processes. Together both documents provided prospective service users or their representatives with a good level of information to enable them to make an informed decision about whether or not the home was equipped to meet their assessed needs. Both documents were last reviewed and updated in June 2008. Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: The last admission to the home was made in June 2007. From the information contained in the file examined it was evident that an assessment record of need had been completed to establish the support required. The record sampled showed that the assessment undertaken had included the individual, their Social Worker and their Parents. All assessments are carried out by either the homes Registered Manager or the Team Leader. Following assessment a transition programme is set up including day visits, visiting for meals and overnight stays. The Manager reported that each transition period may vary in length of time dependant on each individuals needs. Each placement is reviewed at the end of the first three months Care Homes for Adults (18-65 years) Page 16 of 32 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 . Individuals are supported to make decisions about their lives, and are encouraged to take an active role in planning the care and support that they receive. Evidence: Two care plans that had been generated from the homes admission assessment were case tracked. Both plans were found to include information relating to how peoples personal, social and healthcare needs were to be met. The care plans were seen to include records of peoples likes and dislikes. Care plans were in place to support people with their personal hygeine, communication, and managing social interactions. Both of the care plans examined showed that risk assessments were in place covering a range of areas including: self administration of medication, and dealing with social intractions within the community. The risk assessments included management strategies to be followed by staff to minimise the risk to the service users and others. The homes Annual Quality Assurance Assessment (AQAA) stated that there is a key worker system in place within the home. Service users spoken with were aware of who their key workers were and of how they benefited from their support. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Observation of interactions between staff and service users showed that staff supported and encouraged the service users to take responsibilities for making decisions, and staff displayed patience and understanding and listened and responded appropriately. Discussion with staff and observation indicated that people living in the home were supported to make informed choices, and records were in place regarding permission for staff to assist with their finances and medications (copies of these records were seen within the care plans case tracked). Care Homes for Adults (18-65 years) Page 18 of 32 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 . People who use the service are supported to make choices about their life style, and are further supported to develop their life skills. Social, educational, and recreational activities meet individuals expectations. Evidence: The care plans examined contained evidence of a programme of activities that were based on their likes and dislikes and preferences, in terms of how they wished to spend their time both in the home and within the community. From information gained through notices around the home, including service users rooms, it was evident that the home had a stong commitment to enabling, organising and supporting programmes of educational, social and recreational oportunities for people living in the home. The activity notice board situated in the office and in the hallway (Hallway version was Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: presented pictorially) showed evidence that there were a wide range of activities being provided, these included both educational activities and social activities. The homes AQAA states that the home actively supports and encourages people to access the local community and take part in activities that are suitable to their needs. They use local leisure facilities and take part in social groups and clubs. On the day of the inspection visit service users were seen accessing the community both independently and with support. One service user spoken with explained that they had free access to come and go at will. All of the service users have their own back door key and come and go at leisure, although this ability to come and go at leisure is based on each persons level of ability and level of support required by staff. Service users are supported to maintain links with their families and friends. Some are able to do this independently, whilst others are supported to do so by their key workers. One service user spoke of being in weekly contact with their relative. From discussions observed it was clear that service users were supported to stay in contact with friends via the telephone. On a recent hoilday to Blackpool the service users made a new friend and discussion with them indicated that they have chosen to remain in contact with this person, and do so by telephone. Each service user is supported to prepare their own menu plan, and are supported to prepare their own breakfast and snacks. The main meal of the day is eaten in the evening and is flexible to meet the needs of the service users. Service users take part on a rotational basis in its preparation, with support where necessary. Service users are encouraged to take an active role in the shopping of provisions for the home, and are supported by staff in this process. Discussion with service users during the inspection visit indicated that the food provided by the home was good. Care Homes for Adults (18-65 years) Page 20 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The health and personal care that people receive is based upon their individual needs, and they can expect the principles of respect, dignity and privacy to be in place. Evidence: Information relating to how service users required support with meeting their personal needs was noted in their individual care plans. Continuity and consistency of support for the service users was provided for through the key-worker system. Service users care plans examined provided evidence that appropriate healthcare services were available, accessed, and fully recorded following any referral made. Records showed that service users had access to a range of healthcare professionals including:Epilepsy Nurse Specialist, Consultant Psychiatrist, Opticians and Dentists. Hospital services and routine health checks were arranged as necessary and were well documented. All of the service users were registerd with a local General Practitioner. The management of medication was found to be of a good standard with appropriate records in place regarding the ordering, administration and recording of medicines given by staff. The home operates a Measured Dosage System (MDS), and all staff involved in the administation of medicines using this system had received training from Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: the dispensing chemist. At The time of the inspection visit only one service user was receiving any medication administered by staff. Records sampled in relation to this individual were found to be accurate and in order. Care Homes for Adults (18-65 years) Page 22 of 32 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 . People who use the service are supported to express their concerns, and have access to a robust, effective complaints procedure, and are protected by the homes policies and procedures on abuse. Evidence: The home had a complaints procedure that was made available to people living in the home which was clearly written and easy to understand. As mentioned elsewhere in this report reference to the homes complaints procedure was included in the homes Service Users Guide, copies of which were seen in the care plans files examined. Service users spoken with during the course of the inspection visit were aware of who they should speak to in the event of them wishing to make a complaint. The homes AQAA states that any complaints received are addressed promptly and professionally and we work closely with the people concerned to resolve any identified issues as quickly as possible. The Registered Manager reported that there had been no complaints made in respect of the service since the last key inspection visit undertaken, nor have any been received by the Commission. Copies of the homes complaints procedure were seen posted throughout the home. The home had an Adult Protection policy and procedure in place, including Whistle Blowing, and both were comprehensively detailed, including a definition of abuse, as well as the possible indicators of abuse. Discussion with the Registered Manager and comments received in the homes AQAA indicated that all staff had received trainning on Adult protection, this was further confirmed when sampling the recruitment and Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: personal development files of a number of staff during this inspection visit. Discussion with staff during the inspection indicated that they were knowlegeable about and aware of their responsibliities regarding Adult Protection, and were aware of the reporting processes for making an alert. Care Homes for Adults (18-65 years) Page 24 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The physical design and layout of the home enables people to live in an environment that is safe, well maintained and comfortable, in which they may develop their independence. Evidence: A tour of the premises was undertaken in the company of the Team Leader and confirmed that the home provided a physical environment that was appropriate to the needs of the people living there, which was equipped and designed to enable them to maximise their independence. Service users were seen to have unrestricted access to all communal areas of the home, and were seen coming and going throughout the day. Observation of service users indicated that they were happy and contented in their environment, and the atmosphere in the home was homely and welcoming. One service user agreed to show us their bedroom and said how pleased they were with it. The communal areas of the home were pleasantly decorated and provided service users with a number of areas where they could spend time alone if they so wished. The homes laundry facility was domestic in style and was equipped with the necessary equipment to enable the needs of the service users to be met. Service users were supported to take responsibility for their own laundry, either independently or with support from staff if required. Care Homes for Adults (18-65 years) Page 25 of 32 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 . Service users can expect their individually assessed needs to be met by a staff team that are well trained, and available in sufficient numbers to meet their needs. Evidence: Sampling of the homes duty rotas indicated that there were two staff on duty in the home throughout the day, with night time care and support being provided by two sleep-in staff. In addition to these hours the Registered Manager is in the home for two and a half days each week, working in a supernumary capacity. On-call support is provided out of hours and at weekends. Discussion with staff indicated that they felt the homes staffing levels were sufficient to meet the assessed needs of the service users. The home employs six care staff, all of who hold a National Vocational Qualification (N.V.Q) at level 2 or better. This information was provided by the Registered Manager, it was also confirmed by the home in their AQAA. The recruitment files of three members of staff were examined and contained evidence of all of the required information and checks necessary being carried out before they commenced working in the home. These checks included references, proof of identity and Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) clearance. The staff files sampled also contained copies of any relevant qualifications. Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: Staff spoken with and personal development files seen confirmed that they had undertaken relevant training to meet the diverse needs of the people using the service, this training included: sensory training, managing difficult behaviours, supervision and appraisal, infection control, medicines in the care home, first aid, fire safety, adult protection, and epilepsy awareness. Discussion with staff during the course of the inspection visit indicated that access to staff training was good. Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The management and administration of the home is based on openness and respect, and there is an effective quality assurance system in place. Evidence: The homes Registered Manager has day-to-day operational responsibility for 71 Mersea Road and its sister home situated just a short distance away. They are supported by a Team Leader. The Registered Manager has significant previous experience, and completed their Registered Managers award in June 2007. Discussion with staff indicated that the Manager was open and transparent, and provided them with a good sense of leadership and direction. Staff spoken with said that the Manager was always accessible, and would always listen to and acknowledge any concerns or issues they might bring to her. The home had in place an annual process of obtaining quality assurance feedback. This process included sending out questionaires to relatives and other interested stakeholders, as part of the review process. Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: Staff and service user meetings were held every six to eight weekly, minutes of which were seen to be kept. At the time of the inspection visit the Registered Manager reported that Regulation 26 visits were not being undertaken(these are visits that are required under legislation to be carried out by the provider on a Monthly basis). The Registered Manager was reminded of the need for these visits to be undertaken and of the need to ensure that the home be provided with a report of any such visits undertaken, which must then be retained by the home for the purpose of inspection. The homes safe working practices were inspected by looking at a range of records relating to fire safety, fire drills, and electrical installation. Staff training and development files included evidence of training in health and safety, infection control and other health and safety related areas. The home had a comprehensive policy in place regarding health and safety. The records looked at indicated that the home was providing safe working practices which ensures that service users are kept safe. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes  No  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 30 of 32 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 Description 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 Description Timescale for action 1 39 24 The Registered provider must 31/08/2009 carry out Monthly visits to the home as directed under Regulation 26 of the Care Homes Regulations. To enable the registered provider to monitor the quality of the homes service provision. 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 31 of 32 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. 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