Care Home: Downham Cottage

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What the care home does well The service carries out detailed pre admission assessments prior to any person moving in to ensure that they will be able to meet their needs. Detailed care plans and risk assessments are in places, which contain information how peoples needs are met. The service has a structured activity programme, which includes events such as musical entertainers, going to the cinema, out for meals, hydrotherapy, holidays and dancing. People receive well balanced and presented meals which meet with their preferences and they are provided with choices and alternatives What has improved since the last inspection? All recommendations and requirements from the previous inspection reports have been fully complied with. What the care home could do better: The registered provider must ensure that an environmental audit is completed to ensure that all areas of the home are maintained to a safe level for the residents and staff. The registered provider must ensure that all mandatory training for staff is completed. In addition a full and detailed training matrix should be developed for all staff members. A full audit of all staff files must be undertaken by the registered provider to ensure that there are no gaps in the employment and educational histories staff. Key inspection report Care homes for adults (18-65 years) Name: Address: Downham Cottage 111 Longdown Lane South Epsom Surrey KT17 4JL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kenneth Dunn     Date: 2 6 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Downham Cottage 111 Longdown Lane South Epsom Surrey KT17 4JL 01372206230 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: lisamoody@sabp.nhs.uk Surrey and Borders Partnership NHS Trust care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only - (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 (LD). Date of last inspection Brief description of the care home Downham Cottage is a large detached building situated on the borders of Epsom Downs. The home is registered to accommodate eight service users with a learning disability. The service users are all provided with a single bedroom. The lounge and dining rooms are shared communal areas of the home and are easily accessible, spacious and comfortably furnished. The premises have a large garden at the rear of the building and off street parking to the front of the building. Weekly fees range from £1,387.31 to £1,826.90 Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 8 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 peterchart Poor Adequate Good Excellent How we did our inspection: This site visit was part of a key inspection. The visit was unannounced. We arrived at 9.15 am and left at 14.40 pm Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment. (AQAA). This is a self-assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA by the expected date, which provided us with all the information we asked for. Reference is made to this assessment throughout this report. As part of this key inspection we were accompanied by an expert by experience. An expert by experience is a person who because of their shared experiences of using services and/or ways of communicating helped us to get a picture of what it is like to Care Homes for Adults (18-65 years) Page 5 of 26 live in the home and their observations are included in this report. During this visit the expert by experience spent two hours in the service and explored peoples routines, staff interaction, how people are supported to make choices, raise their views, activities, looked at the suitability of the environment and observed the lunchtime arrangements. The expert by experience provided feedback to the inspector and the manager. The expert by experience provided a written report to us of their findings, which are incorporated in this report. Throughout this report they will be referred to as the Expert. Other methods used to inform our judgements made in this report include discussions with members of staff and community health based professionals. We looked at staff recruitment, and training records, care plans, risk assessments, menus, quality assurance systems, medication administration policies, health and safety records and policies and procedures were sampled. We also reviewed other information that we have received since our previous including notifications that the service is required to inform us about. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential residents and there representatives should be provided with accessible information about the home and their needs are assessed prior to admission ensuring that the service will be able to meet them. Evidence: During this visit we looked at the information provided to people that use the service to see whether it is able to supply detailed information about everything that people or their representatives need to know. There is a statement of purpose and service guide has been reviewed and formulated with pictures to make it accessible to people. The statement of purpose however should be further reviewed to ensure that it provides a clearer picture of the home, the services it offers, the registration details of the residents and fuller details of the manager and staff. This was discussed with the manager during the site visit and a further review of the statement of purpose will be undertaken to ensure it offers a full reflection on Downham Cottage, the services and the staff. There have been no admissions over the last year. The service has a clear admission Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: procedure, which includes a comprehensive assessment carried out by a senior member of the management team. Other information is also obtained from the care manager,previous placement and any relevant health care professionals. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a plan of care in place for each person. The residents needs and goals are met and they are supported to make decisions about their life. People are able to take risks as part of an independent lifestyle. Evidence: All residents have a person centred support plan (PCP) in place, which is based on full assessment of needs. Care plans contained information about residents health personal emotional, communication and social and life skills. The overall care plan is reviewed every six months and an annual review takes place,which involves the person if they wish to attend, families, friends, manager, key worker and professionals. During this visit we sampled all current residents plans, which were detailed and comprehensive providing information and guidance to staff as to how people are to be supported. Staff stated that they are supplied up to date information about the needs of the residents they support and the ways of sharing information about people in the home Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: works well. Residents have had an assessment in line with the legislation on the mental capacity act and deprivation of liberty safeguards. The front door which has to remain locked for the safety of people currently living in the service has been risked assessed in respect of deprivation liberty safeguard legislation. The expert however observed a member of staff tell a resident to sit down properly, which the expert considered rude and disrespectful. During this visit we saw a visual staff rota to enable people to identify who is on duty. The service has introduced a range of easy read documents including, the service user guide are produced in easy read formats. Care plans sampled identified how residents choice making is to be supported. Staff spoken with during this visit had a good knowledge and understanding of peoples needs and preferences and they were able to provide examples to us where they assist people to make choices in their daily lives such as supporting them to choose their preferred clothing, meals and drinks. The service has implemented a range of comprehensive risk assessments, which are regularly reviewed and were also supported by detailed and comprehensive strategies and guidelines. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents preferences, social, cultural,religious and recreational interests and needs are met. Residents are supported to maintain contact with their family ,friends , representatives and the local community. People are supported to exercise choice over their lives and they are provided with varied and well balanced meals. Evidence: All residents have an individualised weekly activity schedule, which is outlined in their care plan. At the time of this visit one person was attending day service, an other had decided to stay in bed and a third was with staff in the sitting room. Residents participate in activities in the local community, receive aromatherapy, attend music and there are opportunities to go shopping and attend other local events such as church fetes. Staff spoken with told us about some of the activities that Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: people participate in a member of staff surveyed said, The home has activities that suit each individuals level of understanding and they attend activities during the day, evening and at weekends. The expert observed that the residents have choices of activities and staff do support them well to access these. Going to the cinema, out for meals, hydrotherapy, holidays and music sessions. They are supported to have a choice of when to go to bed and when to get up as was evident on the day, and also due to there being enough numbers on staff both on day and night shifts. Residents are supported to maintain links with their family and friends where these are known. Information supplied in the AQAA states that relatives are encouraged to visit whenever they wish and they are invited to annual review meetings. The manager told us that monthly calls are made to the representatives of residents where appropriate. People and staff were interacting through out this visit and people were moving around the home without restrictions. One person was observed to spend some time in their room, which was respected by staff. The expert observed that although staff stated that the residents who are able undertake household chores like cleaning, doing the laundry and cooking. While at the home I observed one resident laying the table for lunch. The language used to communicate with one residents was seen to be age inappropriate. The manager however stated that this was an agreed method of communication with this resident and details were in the persons care plan. The service has a four weekly menu, which is based on peoples choices and preferences. The menu was varied and well balanced. A comprehensive list was maintained of each persons likes and dislikes. The expert was able to discuss meal planing and staff stated that Residents are involved in menu planning. This is done once a month during a residents meeting. The manager stated that the home will be able to cater for people with specialist diets, but at the time of the visit no person had special dietary needs. In addition the manager said that the advice and liaison takes place with a dietitian where this is required. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All people using the service receive support for their personal care needs and the home ensures that each individual has access to health care support when required. Evidence: Care plans sampled showed that care is delivered at flexible times according to the needs of the people using the service. It was not clear from the plans sampled how each person using the service would be supported by staff for washing , dressing and bathing. The care plans sampled were person centred and contained information about each persons preferences with regard to personal care. All of the people using the service are registered with a local general practitioner (GP). They are able to visit the surgery for routine healthcare check ups and screenings when required. The home also has access to nursing services, dentist and optician who require this facility. The completed AQAA states that the service reviews the provision of care to the residents to ensure that they receive appropriate care at all times. Medication is supplied to the home by a large pharmacy group. The organisation Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: undertakes regular medication audits the most recent was completed on the 19th of July 2009. All residents currently living at the service are assisted with their medication, whoever there is no risk assessments in place to confirm that the residents have been assessed to need staff support and assistance. This was discussed with the manager during the site visit to ensure that clarity in medication support is available risk assessment are going to be completed. The AQAA states that during the last year the home has reviewed and updated their medication management system. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If the people how live at Downham Cottage have any concerns they know how to complain and they are safeguarded from abuse. Evidence: We looked at information provided to people, which tells them about how they can make complaints. During this visit we saw a copy of the homes complaints procedure,which included the timescale for investigating any complaints and the contact details for the Commission. The procedure is available in easy read format guide and there is also an accessible complaints form. The manager and the AQAA provided evidence that the service has not received any complaints in the last 12 month period. Due to the communication difficulties of some people they would not be able to make complaints but this would be observed by any behavioural changes. The resident are protected by the homes safeguarding procedures, although some staff training is out of date the AQAA does state that they have all had the training in the past. Safeguarding was discussed with the manager and it was agreed that safeguarding training must be given priority to ensure that the residents continue to live in safety and security. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is in the main safe, comfortable, homely and clean Evidence: The service is situated in a residential area in Epsom Surrey and provides a homely comfortable, relatively well maintained and furnished for people to live. There is a of planned maintenance and improvement plan in place. The service provides a sitting room, kitchen and separate dining room, eight single bedrooms and there is sufficient bathrooms and toilets to meet the needs of the residents . There is a large and relatively unaccessible garden, abandoned stables and terrace at the rear of the home, which is maintained to a good standard. The manager stated that due to mobility issues the residents prefer to stay on the terrace area to enjoy the outside. The expert stated that the garden is only partially accessible up to the patio. The rest of the garden, and the stables at the bottom of the garden are not accessible by residents. During this visit we viewed one occupied bedroom after permission was grained from the resident, which was decorated and furnished in a comfortable and personalised way. During the visit all five unoccupied rooms were seen again these were relatively well decorated and ready for a new resident. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: During the visit the expert was invited by one resident to view her bedroom, which the expert stated was nicely furnished with her personal items. She said she loves her bedroom and staff support her to keep it neat and tidy. During the tour of the premises the following areas were highlighted for need and attention. The upper hall carpet would benefit from being replaced as there is areas that were ripped and frayed. The assisted bathroom on the first floor had areas of damp on the external wall. The floor on the ground floor assisted bathroom requires to be repaired and resealed. The ceiling in the dining room requires to be repaired. The light fittings in both the sitting and dining rooms had missing glass shades that had been removed as they were broken. During this visit the home was observed to be cleaned to a very high standard and was hygienic. Suitable hand washing facilities and equipment were available and cleaning schedules were in place. Infection control procedures are available and staff receive training. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by staff that are competent and trained to meet their needs. The residents should be protected by the homes recruitment policies and practises. Evidence: At the time of this inspection the registered manager was on duty with three members of staff. Information recorded on the staff rota verified that that there always sufficient members of staff on duty during the day supporting the residents. The staff team are of mixed gender, age and culture. People living in the service benefit from a stable staff that know them well and staff turnover has been minimal. A random sample was undertaken of six staff members training records, this highlighted several gaps within the training of staff and areas where the training had taken place but was out of date at the time of the visit. The manager stated that the training records were not up to date and that the organisation places good emphasis on staff training. Information supplied in the AQAA, stated that there is however a commitment by the service to staff undertaking National Vocational Qualifications (NVQs), with five staff members holding an NVQ level 2 in care and a further two working to wards this award. The training gaps were fully discussed with the registered manager during the site visit and a requirement was made to ensure that Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: all staff receive their mandatory training. The expert observed that Staff receive good and continuous training to support the changing needs of the residents. Staff recruitment is based on equal opportunities. During this visit we sampled four members of staff personal files, which contained some of the required information, however two files contained completed application form where there was gaps within the employment history of the staff member, a further two files had only one written references. This was discussed with the manager who stated that a full audit would be undertaken to ensure that any gaps or missing items would be rectified and changes would be implemented. However all staff have enhanced criminal records bureau checks (CRB). Staff are provided with the code of conduct ensuring that are aware of their role and responsibilities working in a social care setting. Staff receive regular formal supervision and appraisals,which was confirmed during discussions with staff records viewed and staff surveys that were returned. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run in the best interests of people living there and their wellbeing, health and safety is in the main protected. Evidence: During this visit the registered manager was observed to have an open approach and made themselves accessible to both people using the service and staff. Staff spoken with said that they felt supported by the manager, there was good communication, teamwork and regular meetings take place. Systems are in place to ensure that the views of people are sought as part of the homes quality assurance systems. The outcomes of feedback of surveys viewed were analysed. However the families and other representatives of the residents are not requested to participate in the survey, this was discussed with the manager and the QA process will be opened to all relevant individuals. We were informed that the organisation undertakes regular monthly regulation 26 quality monitoring visits, these were available for us to see at the time of this visit. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Monthly health and safety checks are carried out and any matters identified are actioned. Staff training records sampled demonstrated that they receive statutory training including, first aid, fire awareness, food hygiene, moving and handling and health and safety. Records were maintained to demonstrate that regular water temperature monitoring is conducted. Hazardous cleaning materials were stored and locked away securely. The service maintains incident and accident records. Routine servicing and maintenance of facilities and equipment were up to date. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 The registered provider must ensure that the staff receive all mandatory training. To ensure that all staff have sufficient training to provide appropriate care to the residents. 28/01/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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