Care Home: Cotswold Court

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What the care home does well All of the people living in the home have care plans that identify their needs. These plans provide staff with instructions as how they should meet peoples` needs.People lead active lifestyles supported by staff as required.I want to make a complaintSpeaking to people living in the home it is clear that when they have been unhappy previously they have felt able to make a complaint.The home is decorated to high standard throughout, it is comfortable, warm and homely. It has specialist adaptations make it accessible to people with physical disabilities.Staff training helps to ensure that peoples needs are being met by appropriately qualified staff.Records relating to peoples health needs were detailed and it was clear that all health issues are dealt with promptly and effectively. What has improved since the last inspection? Picture care plans have been introduced to make it easier for people with communication difficulties to understand their plans of care.People are given more choice about the staff who will support them to complete activities/care each day. What the care home could do better: There should be more evidence about how peoples goals are met. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cotswold Court Browns Lane Stonehouse Glos GL10 2JZ 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: Paul Chapman Date: 1 9 0 6 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: Cotswold Court Browns Lane Stonehouse Glos GL10 2JZ 01453828275 01453756192 Cotswoldcourt@tesco.net 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) : Stroud & District Mencap Homes Foundation Limited care home 6 Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability- Code LD The maximum number of service users who can be accommodated is 6. Date of last inspection 0 9 0 8 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Cotswold Court is a residential care home for 6 adults with learning disabilities. The home is situated on the outskirts of the town of Stonehouse and is set in large grounds that it shares with another house. This other house provides supported tenancies for adults with learning disabilities and was formally a registered home. Both these properties are owned and maintained by the Stroud and District Mencap Society. The house provides spacious and homely accommodation, with all single bedrooms having en-suite facilities. The home provides twenty-four hour staffing and is well situated to access local facilities and amenities. The home has symbol-based versions of the Statement of Purpose and Service User Guide. The weekly fees for living in the home are dependant on a person’s assessed needs. Care Homes for Adults (18-65 years) Page 5 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 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home This was a key inspection that focused on the core standards relating to adults and was undertaken by regulation inspector. The report has been written using accumulated evidence gained prior to and during the inspection. The manager was present for part of the inspection and they provided the information that we requested promptly and in an open manner. We spoke with three people who lived in the home. Care Homes for Adults (18-65 years) Page 7 of 32 We spent time with 2 people looking at their care plans and talking about living in the home. We spoke to 5 staff working at the home. We viewed records that were kept in the home, which included health and safety records. Other records that were viewed are identified in this report. Care Homes for Adults (18-65 years) Page 8 of 32 Prior to the inspection we sent an AQAA (Annual Quality Assurance Assessment) and surveys to the home. We received the AQAA and completed questionnaires from staff and people living in the home. What the care home does well All of the people living in the home have care plans that identify their needs. These plans provide staff with instructions as how they should meet peoples’ needs. Care Homes for Adults (18-65 years) Page 9 of 32 People lead active lifestyles supported by staff as required. I want to make a complaint Speaking to people living in the home it is clear that when they have been unhappy previously they have felt able to make a complaint. The home is decorated to high standard throughout, it is comfortable, warm and homely. It has specialist adaptations make it accessible to people with physical disabilities. Staff training helps to ensure that peoples needs are being met by appropriately qualified staff. Care Homes for Adults (18-65 years) Page 10 of 32 Records relating to peoples health needs were detailed and it was clear that all health issues are dealt with promptly and effectively. What has got better from the last inspection Picture care plans have been introduced to make it easier for people with communication difficulties to understand their plans of care. People are given more choice about the staff who will support them to complete activities/care each day. Care Homes for Adults (18-65 years) Page 11 of 32 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: Paul Chapman CQC South West, Citygate, Gallowgate, Newcastle upon Tyne, NE1 4PA Telephone: 03000616161 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 . The service has an admissions procedure that they would follow when admitting someone. Evidence: The service has an admissions policy. No one has been admitted to the service since we completed the previous inspection. We did not score against this standard as it was impossible to judge the effectiveness of the process without an admission. The AQAA states that an area the manager feels they could do better in is developing a picture assessment document for people with communication difficulties. As an organisation the use of pictures in documents is an area of development at present. Care Homes for Adults (18-65 years) Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Care plans provide comprehensive information about peoples needs and the steps staff must take to meet peoples needs/wishes consistently. Care plans are person centred and developed with the input of each person and this helps to ensure they meet peoples needs. The service provided at the home is led by the needs and the decisions of the people living there. Potential risks to people are identified and minimised where possible, but people are still able to take acceptable risks. Evidence: We met with 2 people living in the home individually and discussed their care with them. Each person allowed us to examine their care files that contained care plans, risk assessments, IPPs (Individual Programme Plan) and other documents relating to their care. We sat with each person and asked them to talk us through their care. Through these discussions it was clear that both people were involved in producing their care plans and IPPs. Each person had also signed documents confirming that they agreed with them. Each person had a wide range of care plans to meet their assessed needs. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: Looking at peoples IPPs they provide a summary of peoples life at the home, their health, family/friends/relationships and ask them to identify goals they wish to achieve. It was clear that goals were being worked towards, but records to support this were difficult to find. We discussed this with the manager and it was agreed that in the future better recording keeping is needed to enable an accurate review of the persons progress towards their chosen goal. This becomes a recommendation of this inspection report. When speaking with 1 person they explained that they meet with staff monthly to discuss care plans and their IPP. The person said staff ask me if Im OK, and whether I need anything. Speaking with both people they were able to provide examples of where they are asked to make decisions about their lives. Examples we saw, and were told about included daily activities, food/meals and holidays. Both of the files we examined contained a range of risk assessments that identified areas of potential risk and provided the reader with guidelines to minimise those risks. The AQAA states that a planned improvement for the next 12 months is to expand the use of picture care plans (this has been started in care plans for personal care, see evidence for standard 18). Care Homes for Adults (18-65 years) Page 17 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 lead active social lives and staff provide support to enable them to do this when it is required. People are empowered to make choices about the food they want to eat and there is a good range of meals are available. Evidence: People living in the home take part in a range of activities. We saw examples of people using a local sport centre to take part in keep fit sessions, including playing badminton, aquatrim and the gym. During weekdays people attend a local college and day services. Staff support people to attend college. Speaking with people in the home they stated that staff support them to use facilities in the local community and surrounding areas. When people are at home they have the opportunity to take part in activities occluding listening to music, watching TV, Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: gardening and some art work. People we spoke to confirmed that they had been on holiday last year and explained that they are currently planning this years holidays. one person said that they do not like going away on holidays and have decided to have day trips instead. We examined a copy of recent house meeting minutes. These were detailed and written in plain English. The minutes showed it had been agreed that a strawberries and cream afternoon would be held at the home for friends and family in July. The manager went onto explain that at Christmas they usually hold a similar event with mince pies. Speaking to 1 person they said that their family visit regularly and that sometimes they attend a local church. When people are at home staff encourage them to complete day to day chores including cleaning and cooking. Speaking with people in the home they said that each week staff sit with them and support them to choose meals. Staff do this by using pictures of meals which enables people with communication difficulties to choose what they like more easily. All of the people we spoke with were happy with the food served in the home and agreed that there was always choice. 1 person we spoke to explained that they liked fish and chips, and that they were able to have this regularly, they also said they enjoyed baking cakes, and that they do this regularly. There is a picture menu that staff change daily to show what is for tea that day. The AQAA states that a planned improvement for the next 12 months is to provide a small table in the lounge so to allow people more choice of where they wish to eat. Also to continue actively enabling people to become part of the local community. Care Homes for Adults (18-65 years) Page 19 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 risk of peoples personal care needs not being met are minimised through staff having detailed plans to follow that are regularly reviewed. Where required the home make good use of other medical professionals to meet peoples needs. The homes medication procedure minimises potential risks to people living in the home. Evidence: Since the previous inspection was completed the manager has introduced a system of enabling people to choose who provides their personal care each day. People are enabled to do this with the use of photos where necessary, the photo of staff is then put on their bedroom door. Each person who requires support with their personal care has a plan in place that details their requirements. The plans we sampled provided the reader with sufficient detail about the persons needs and what support the person needed. In addition to these written plans picture plans have been developed and are displayed on peoples bedroom walls. We spoke to the manager about this and suggested that the picture care plans are kept in a file rather than on the wall as this will protect potential threats to peoples privacy and dignity. This becomes a recommendation of this inspection report. Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: The sample of records we examined provided good evidence of people being supported to access the appropriate medical professionals to meet their needs. Each person has a completed health care assessment, the manager explained that about 90 of the people in the home have recently changed to a different surgery. As a result the practice Nurse visited the home and completed a health care assessment with each person. Nobody currently living in the home manages their own medication and this is done by appropriately trained staff. We examined administration and storage which were both seen to meet the standards of these regulations. Care Homes for Adults (18-65 years) Page 21 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 . The home has a complaints procedure and people stated that they are able to make a complaint if they are unhappy. Potential risks to people are minimised through staff training in safeguarding vulnerable adults. Records of income and expenditure for people who do not manage their own monies are comprehensive and minimise potential risks. Evidence: The AQAA we received stated that there had been no complaints made to the manager since the previous inspection was completed. We spoke to the manager about this and they confirmed that no complaints had been made since we received the AQAA. The manager explained that there are plans to review the current complaints procedure making more use of symbols and pictures. At present the document is produced in an easy read format, but the manager feels that a review could make this better. The 2 people who spoke to us about their care agreed that if they wished to make a complaint they could. 1 person said that when they had complained previously they had been happy with the outcome. Nobody living in the home displays any behaviour that challenges, therefore staff have not completed in training in behaviour management. All of the established staff have completed training in safeguarding vulnerable adults, new staff have been booked on a course in the near future. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: Each person has a financial management plan and these are supported by risk assessments. People are supported to manage their own finances as much as possible. 1 person goes and collects their monies from the post office and 2 people hold their own monies. Where monies are kept in the homes safe staff keep detailed records of income and expenditure. Each person has a lockable facility in their bedroom to store valuables securely. Care Homes for Adults (18-65 years) Page 23 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 home provides people with a comfortable, clean and homely environment that meets their current needs. Evidence: The AQAA identifies that over the past 12 months a number of rooms have been decorated, new floor coverings have been fitted, new beds purchased and alarms have been fitted in some peoples bedrooms to enable them to call staff for assistance if required. Plans for further improvements in the next 12 months include re-styling the garden to include raised flowerbeds. We completed a tour of the premises with the staff and this showed that the home was clean, tidy and well maintained. The kitchen is accessible to all people and cupboards and drawers have symbols on them to help people know where items are. Communal areas are decorated to a good standard and there is a separate lounge and dining room. The lounge provides a range of good quality furniture and a TV/DVD player and sound system. The dining room has a table large enough for everyone to sit around. All the communal areas were decorated with photos of people in the home and personalised with peoples possessions. Each person has their own bedroom and we were able to see all of them during our 2 site visits. Each of the rooms was decorated to a good standard and where required adapted to meet peoples specialist needs. Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: All bath/shower rooms were seen were seen to be decorated to a good standard and where specialist equipment is in use (assisted bath) it has been serviced appropriately. The home has a stair lift and this was seen to be serviced appropriately. 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 . People living in the home are protected by the homes recruitment procedures. People living in the home are involved in the recruitment of new staff and their opinions are taken into account when deciding who will work at the home. Staff are employed in sufficient numbers to ensure that peoples needs are met. The home has a training programme that addresses areas classified as mandatory training as well as training specific to meet the needs of people in the home. Evidence: We examined the staff personal files for 3 staff employed since the previous inspection. All of these files were seen to contain the information required by these regulations. Records showed that new staff may start work without a CRB (Criminal Records Bureau disclosure) but do not work unsupervised until the manager receives the CRB. New staff have either completed, or are completing a structured induction (Skills for Care). People living in the home are involved in the recruitment process with potential staff invited to join people in the home for a meal. After the meal people will be asked to comment on what they thought of the person and this is used as part of the recruitment process. The home has a settled staff team with many of them being there for a number of years. The staffing rota shows that usually there are 3 staff on duty during day time hours, and at night 1 member of staff sleeps in. Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: All of the staff we spoke with agreed that the training available to them meets their needs. This was supported by a copy of the training matrix provided by the manager. The training matrix showed a wide range of courses being completed over the past year, with a number of courses being booked for the coming year. 6 of the staff have completed NVQs (National Vocational Qualification) in care to level 2 or above. Staff supervisions are being completed at regular intervals and this is 1 of the tools used to help identify future training for staff. In addition to this staff also receive annual appraisals. 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 home is managed by a competent and highly experienced manager and this is shown in the positive outcomes for people living in the home. Quality assurance of the home is being addressed with people living in the home being asked their opinions and wishes for the future. Health and safety procedures and training completed by staff minimise potential risks to people in the home. Evidence: The registered manager has been in post at the home for a number of years and therefore have an extensive knowledge of the people they support. They are qualified with an NVQ level 4 in Management and have recently completed the Registered Managers Award (RMA). Observations throughout our site visit support the managers comment in the AQAA that they lead in an open and inclusive way. Comments from staff also supported this. The home has a wide range of policies that cover the titles set out in these regulations. The manager stated that they will all be reviewed in the next few months. As part of the review process the manager said that the policies will also be supported with symbols/pictures to make them more user friendly. This is good practice and we had a Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: discussion about the importance of also simplifying the language used in policies to make them easier for people to understand. People living in the home are consulted about the service. We saw examples of this in house meeting minutes and form notes in their personal files/daily notes. This was further supported by speaking to people in the home. This year the home has produced an annual plan for quality assurance that identifies a number of timeconstrained goals they wish to achieve. We discussed the different goals and their progress towards meeting them. Clearly there is progress towards meeting these goals but some of the timescales are in need of review to ensure they are realistic. A goal of the plan is to send questionnaires to other professionals and relatives asking for their opinions of the service, this Had not been achieved as yet. Each month staff complete audits of different areas of the service. Staff take it in turns to do this and we saw good records of the audits being completed over a period of months and corrective action being taken as required. Where a service provider is not in day to day charge of the service the regulations state that they must complete monthly unannounced visits to the service (Regulation 26). Records showed that these visits are completed in line with the Regulations. Health and safety procedures and training completed by staff ensure that people living in the home are not put at unnecessary risks. We identified 1 shortfall with the fire safety equipment servicing, this was brought to the attention of the manager who assured us this would be addressed. 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 The manager should ensure that there are records available to support each persons progress towards meeting their identified goals. The manager should ensure that the picture care plans produced to meet peoples personal care needs are stored appropriately to protect peoples privacy and dignity. The manager should review the goals identified in the quality assurance plan to ensure they are achievable. The manager should send questionnaires to relatives and other professionals asking their opinions of the service. These comments should then form part of the future quality assurance report. 2 19 3 4 39 39 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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