Care Home: Crebor Street

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What the care home does well Prospective residents have the information and support they need to help them to decide whether they want to live in the home. They can visit and experience life in the home before moving in and emphasis is placed on making information as accessible as possible. The assessed and changing needs of each resident are reflected in the individual plans for how they are to be supported. Residents are supported to contribute their own goals and ideas to these plans and they are given support to make decisions if necessary. Risk assessment and skills development plans are used to encourage an independent lifestyle as possible. Residents are part of their local community and they each have opportunities for leisure and skills development. A healthy diet is being encouraged and provided. The views of residents are listened to and acted upon and they are protected from abuse, neglect and self-harm. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Residents receive the right amount of support to maintain their personal care and grooming. Physical and emotional health care needs are recorded and addressed with input from appropriate specialists. The home is comfortable and clean, and steps are being taken to ensure that a resident has the appropriate bathroom facilities to meet an increasing mobility need. Staff are well trained and supervised and many have worked in the home for many years. This means that residents get to know the staff well and there is a consistent service. What has improved since the last inspection? There is a new colour television in the communal lounge. One of the resident`s bedrooms has been redecorated. Each resident has an accessible plan for their healthcare. Staff have supervision meetings with a manager more often. What the care home could do better: Key inspection report CARE HOME ADULTS 18-65 Crebor Street 2 Crebor Street London SE22 0HF Lead Inspector Sonia McKay Unannounced Inspection 19th May 2009 09:15 Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Crebor Street Address 2 Crebor Street London SE22 0HF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8693 4153 020 8693 8198 2crebor@odyssey-csft.org www.odyssey-csft.org Odyssey Care Solutions for Today Jonathan Chalses Care Home 5 Category(ies) of Learning disability (0), Physical disability (0), registration, with number Sensory impairment (0) of places Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th May 2008 Brief Description of the Service: The home is registered to provide a residential care service for five people with learning disabilities. There are 5 single bedrooms. The home is made up of two houses converted to make one larger home and garden. It is in a residential area of East Dulwich, close to public transport routes and local facilities, which include pubs, shops, restaurants and a post office. Prospective residents are given a copy of the Service Users Guide that gives information about the home and the services provided. A copy of the most recent Commission inspection report is available, on request, from the staff office. Fees range from £1067.48 to £1696.05 per week and depend on the individual care needs of each person. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience Good quality outcomes. This unannounced key inspection was carried out in three hours by one inspector. The methods used to assess the quality of service being provided include: • • • • • • • Talking with the interim home manager and staff on duty Looking at the Annual Quality Assurance Audit document completed by the registered home manager (this document is sometimes called an AQAA and it provides the Commission with information about the home) A tour of the premises Looking at records about the care provided to two of the residents Looking at two surveys completed by key staff on behalf of two of the residents Looking at the way medicines are handled by staff in the home Looking at issues that the Commission has been notified about since the last inspection and how they were handled The Commission would like to thank all who kindly contributed their time, views and experiences to this inspection process. What the service does well: Prospective residents have the information and support they need to help them to decide whether they want to live in the home. They can visit and experience life in the home before moving in and emphasis is placed on making information as accessible as possible. The assessed and changing needs of each resident are reflected in the individual plans for how they are to be supported. Residents are supported to contribute their own goals and ideas to these plans and they are given support to make decisions if necessary. Risk assessment and skills development plans are used to encourage an independent lifestyle as possible. Residents are part of their local community and they each have opportunities for leisure and skills development. A healthy diet is being encouraged and provided. The views of residents are listened to and acted upon and they are protected from abuse, neglect and self-harm. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 6 Residents receive the right amount of support to maintain their personal care and grooming. Physical and emotional health care needs are recorded and addressed with input from appropriate specialists. The home is comfortable and clean, and steps are being taken to ensure that a resident has the appropriate bathroom facilities to meet an increasing mobility need. Staff are well trained and supervised and many have worked in the home for many years. This means that residents get to know the staff well and there is a consistent service. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 4. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have the information and support they need to help them to decide whether they want to live in the home. They can visit and experience life in the home before moving in and emphasis is placed on making information as accessible as possible. EVIDENCE: The Statement of Purpose was revised in February 2008. This document sets out the purpose of the home and gives information about how the service is run. The Service Users Guide to the home is produced in a visually accessible format using colour photographs to make it easier to understand. There is a set of policies about how the home runs. Some have been produced in a visually accessible format. Accessible policy includes a breakdown of how resident contributions and local authority placement fees are spent. This additional information, along with the Service Users Guide, provides prospective residents with the necessary information about placement costs. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 9 Prospective residents have an opportunity to visit the service before making a decision to move in and the registered provider obtains a community care assessment of need from the placing authority before completing their own assessment, records of which are held on file. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. People using the 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 assessed and changing needs of each resident are reflected in the individual plans for how they are to be supported. Residents are supported to contribute their own goals and ideas to these plans and they are given support to make decisions as necessary. Risk assessment and skills development plans are used to encourage an independent lifestyle as possible. EVIDENCE: Staff maintain records of the care and support required by each person living in the home. There are currently three residents and two sets of records were looked at during this inspection. Records are stored securely in a staff office. The information is up to date and plans are centred on each person and their needs and goals. Plans are reviewed and regularly and are changed when required. There is clear information for staff to follow. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 11 Individual profile information details the level and nature of support required in the areas of communication, community access, behaviour management and personal care. There is also information about important relationships, spirituality and culture, weekly and daily routines and leisure activity choices. Staff work with health professionals from the local multi-disciplinary team to develop a wide variety of methods to aid communication. Visual aids, such as objects of reference and pictures, are in place to enable residents to make choices in their day-to-day lives. Advocates are involved in planning and decision making as necessary. Each person has a named key worker, a member of the staff team with special responsibility to assist with planning and associated administrative tasks. The key worker produces monthly reports about how things are going and progress in achieving identified goals is monitored and recorded. Risks relating to each resident are documented and reviewed frequently. Risk assessments consider activities of daily living and community based activity. This helps residents to develop their independence within a risk management framework. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16 & 17. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are part of their local community and they each have opportunities for leisure and skills development. A healthy diet is being encouraged and provided. EVIDENCE: Each resident has a weekly plan of activities. Current residents all need staff support to access the community safely. Levels of household participation and community activity are monitored and recorded. Each person has opportunities to get involved in household tasks to the best of their ability and to take part in activities and groups in the community, such as day services. Staff help residents to maintain their friendships and relationships. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 13 There are outings to places of interest and an annual holiday with staff support. There are also opportunities for leisure, education and employment. There is use of a house vehicle and some staff are also drivers. A cleaner comes to the home twice each week. This maintains a standard of cleanliness. However, residents are encouraged and supported to get involved in aspects of cleaning their bedrooms, shopping and cooking. Residents help to plan the weekly menus with staff and a member of staff related the various likes and dislikes of residents, some of whom have limited verbal communication. A record is kept of the meals served. One resident has health needs that mean a nutritional supplement has been prescribed and another is on a weight reduction plan that is being carefully reviewed and amended to ensure the resident is still able to enjoy meals and snacks at the times that he prefers. Food stocks were good and contained plenty of fresh produce. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive the right amount of support to maintain their personal care and grooming. Physical and emotional health care needs are recorded and addressed with input from appropriate specialists. Medication administration is adequate but could be improved by fewer administration errors. EVIDENCE: Residents need support to maintain their personal care. Preferred and required routines are laid out in specific plans for each area of personal care. Plans also document the level of support required, this can range from verbal prompting to actual assistance. All assistance is carried out in the privacy of bedrooms and residents are encouraged to be as independent as possible. Occupational therapists have assisted by planning an en-suite bathroom suitable for use by one of the residents. The bathroom is due to be re-fitted as advised this year. There are clear records of peoples healthcare needs and of the healthcare they receive. Records show that staff maintain healthcare information well and refer Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 15 to local specialist teams when required. One resident is developing dementia and the staff are working closely with professionals to establish a baseline assessment and to monitor and record changes in behaviour. There is also input from speech and language, occupational and behavioural therapists as required. Health action plans have been developed with each resident since the last inspection. The documents are accessible. All of the current residents receive support from staff to take their medications, although there are plans to support one resident to begin self medicating. There are policies and procedures to tell staff how to administer medication properly and all staff are trained. Medications are stored properly. There is controlled drugs storage available although none are prescribed at this time. Medication administration records have been completed properly and there are no gaps in recording in current records. In the AQAA (Annual Quality Assurance Audit) the registered home manager assessed that medication administration could be improved with more robust procedures. He changed to a supplying pharmacy that used a measured dose system. A pharmacist visited the home in September 2008 and assessed most areas of storage and administration as good. They note that no home remedies are available. One resident is prescribed a regular analgesic (pain relief) for a medical condition, but there is no stock of home remedies for use by other residents. Staff said that if they noted any signs of pain they would arrange a GP appointment. A list of home remedies has been agreed with the GP. This list should be reviewed with each residents GP (to ensure no contra-indications with currently prescribed medications) and stock obtained as advised. There are regular daily checks on administration and staff seek urgent medical advice if they note any administration omissions or errors. There have been several medication errors and omissions in the last twelve months. Details of two logged medication errors could not be located during this inspection. The interim home manager is in the process of changing the supplying pharmacy to a local one as the new pharmacy was proving difficult to get to as it is further away. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People using the 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 views of residents are listened to and acted upon and they are protected from abuse, neglect and self-harm. EVIDENCE: The home has an accessible complaints policy and procedure and there is a book for staff to record concerns, complaints or compliments. The home has an accessible complaints policy and procedure and there is a book for staff to record concerns, complaints or compliments. The record shows that concerns and complaints have been addressed appropriately and the outcomes are recorded. Staff encourage discussion and try to monitor issues raised as concerns so that they can be addressed before they develop into problems and complaints. This is good practice and is appropriate in a service for people with a learning disability, who may find formal complaints difficult. A copy of the local authority (Southwark Social Services) safeguarding adults’ policy and procedures are available for staff reference. Staff undertake training in safeguarding and recognising abuse. There have been no safeguarding investigations since the last inspection visit. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 & 30. People using the 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 comfortable and clean, and steps are being taken to ensure that a resident has the appropriate bathroom facilities to meet an increasing mobility need. EVIDENCE: The home is comfortable and decorated in a homely manner. On the day of the inspection the home was clean and there were no unpleasant odours. The home is in a residential area and is in keeping with other homes in the area. There is sufficient communal space and a large back garden with planting and seating area. There is a communal lounge with a new television. All bedrooms are single occupancy and the bedroom seen during this inspection was newly decorated and personalised. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 18 There are a sufficient number of toilets, bathrooms and hand-washing facilities. One bedroom has an en-suite bathroom that is due for refurbishment. Advice about adaptations required to meet the increasing mobility needs of the occupying resident has been taken and quotes have been taken up for the work, as recommended in previous inspection reports. Work is due to start in the next six weeks. One bathroom ceiling has a signs of mould, and ventilation may not be working well. The mould has extended to an adjacent bedroom ceiling as well. This must be addressed. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and supervised and many have worked in the home for many years. This means that residents get to know the staff well and there is a consistent service. EVIDENCE: There is twenty four hour support that includes a member of staff staying awake at night in case assistance is needed. There is consistent support and the staff on duty knew residents well and were able to talk about needs, communication methods and their likes and dislikes. There are normally two or three staff on duty depending on the activity plans of the residents. Staff said that they felt adequately supported and supervised. Staff supervision meetings are now split between the home manager and deputy and are subsequently occurring more often. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 20 There are nine support staff and eight have achieved a vocational qualification in care. The service aims to support one member of staff to start studying for a vocational qualification in care (NVQ at level 2 or above) this year. Staff also attend specialist training provided by the registered provider and specialist health teams in the area. There is an induction programme in place and staff also attend mandatory refresher courses as required. No new staff have been recruited since the last inspection visit, when recruitment practices were assessed as good. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are regular checks on the safety of the home and equipment used in it. This makes it safer for staff and residents. EVIDENCE: The manager has registered with the Commission and is experienced and qualified. However, there are interim management arrangements in place as the registered manager is temporarily moved to another service. The interim manager is experienced and qualified and is registered to manage a similar service in the locale. She is currently managing both services and dividing her time between the two. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 22 These arrangements were reported as being in place since the beginning of May 2009 and at the time of writing this report it is unclear as how long they will last. The Commission must be notified if the registered manager is absent from the service for over twenty eight days. There are monthly inspection visits by a senior manager. Reports of the outcome of these inspections are filed in the home and action points are given to the manager and staff to address. This is a way for the registered provider to monitor how well the home is running. The AQAA (Annual Quality Assurance Audit) states that the views of residents and other stakeholders are sought and used to inform plans for the service. Staff conduct a range of daily and weekly environmental safety checks and checks on fire alarms. Hot water temperatures are tested and recorded, along with fridge and freezer temperatures. Professional checks are conducted on gas and electrical appliances and fire fighting equipment. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Version 5.2 Page 24 Crebor Street DS0000060238.V374936.R01.S.doc No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23 Requirement Mould on a bedroom and bathroom ceiling must be removed and the area treated and redecorated. Steps must be taken to reduce the number of medication administration errors. Timescale for action 31/08/09 2. YA20 12 13(2) 31/07/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations Home remedies should be available as advised by each person’s GP. Crebor Street DS0000060238.V374936.R01.S.doc Version 5.2 Page 25 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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