Care Home: Dugdale House

Similar services:

• Coopers Mill Ltd
• Bramley Avenue (73)
• Paradise Lodge
• Grangewood
• Upaya Ananda
• Newton Court (1-2)
• Kings Lane (32)
• Pemdale

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Dugdale House 1 Santers Lane Potters Bar Hertfordshire EN6 2BZ 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: Sheila Knopp Date: 1 4 0 4 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 34 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 34 Information about the care home Name of care home: Address: Dugdale House 1 Santers Lane Potters Bar Hertfordshire EN6 2BZ 01707642541 01707643653 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) : Caretech Community Services Ltd care home 8 Number of places (if applicable): Under 65 Over 65 6 2 learning disability Additional conditions: Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Dugdale House is situated in a residential area on the outskirts of Potters Bar. Residents are able reach local shops, sport and transport services. It is run by CareTech Community Services Limited. The home provides full care services for eight service users with learning disabilities. Dugdale House does not have a lift so would not be suitable for people with mobility problems if they had a room on the first floor. Dugdale House has its own transport to enable people to get about. Care Homes for Adults (18-65 years) Page 5 of 34 The two storey detached house was converted into a care home in 1998. There is a front driveway and parking facilities. The office, lounge, dinning room, kitchen and two bedrooms, with en-suite facilities, are on the ground floor. The other six bedrooms are on the first floor. These have no en-suite facilities. Shared toilets and bathrooms are nearby. Each person has their own room. There are spacious gardens to the front and back of the house. The current fees for the services range from 1200 1500 pounds per week subject to individual contractual arrangements with funding authorities (correct on 14/4/09). Information about the home in the form of a Statement of Purpose and Service User Guide can be requested from the Care Homes for Adults (18-65 years) Page 6 of 34 manager together with a copy of the latest inspection report. Information about the service provided at Dugdale House and copies of inspection reports can be obtained from the manager. Care Homes for Adults (18-65 years) Page 7 of 34 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 8 of 34 How we did our inspection: This is what the inspector did when they were at the care home Our last full inspection was on 18/4/07. We carried out a pharmacy inspection, followed by a review in 2008, as we felt people were being provided with a good - 2 star service. The review did not involve a visit. For this visit one inspector visited Dugdale House in the afternoon to meet people as they came back from their day time activities. We had not told anyone we were coming. We met all the people who live at Dugdale House. One person was at home when we arrived. They showed us around the home and their own room. We walked around the home and garden and looked at how well they are looked after. Care Homes for Adults (18-65 years) Page 9 of 34 Four people have sent us surveys telling us what they think about Dugdale House. Three were relatives and one was a health worker. The manager sent us a long document called an AQAA. This is a report that the manager uses to tell us how well the people at Dugdale House are being looked after and how things might be able to be made better. It also has some interesting facts and figures for us to look at. While we were in the home we talked to people who work there and to the manager. We looked at some of the important paper records about the way the home is run. These included details of how people who live at Dugdale House are helped with any medicines they need to keep healthy. We also looked at how care plans are put together. Care Homes for Adults (18-65 years) Page 10 of 34 What the care home does well Relatives felt the people living at Dugdale House were well looked after and they were made to feel welcome when they visited. When we were in the home everything was calm. Staff had time with people as they came home and settled down. Each person living at Dugdale House has a plan of how they spend their time and things they like to do. Care Homes for Adults (18-65 years) Page 11 of 34 The records that help staff to care for the people living at Dugdale House were well organised and up to date. The staff we spoke with had been checked to work in the home and have further training to help them in their jobs. What has got better from the last inspection The systems for giving people their medicines have improved. Care Homes for Adults (18-65 years) Page 12 of 34 There is now a driver who can take people out during the week and at weekends. Some areas of the home have been redecorated but there is still some work to do. Someone has been organized to look after the gardens. This means they are kept neat and tidy. What the care home could do better Care Tech have had a look at the decoration, furniture and fixtures and listed the things that need to be replaced to make sure the home is kept to a good standard. Care Homes for Adults (18-65 years) Page 13 of 34 We have asked the manager to review the menu choices as it seems people are having very similar things on the same day. We have asked the manager to look at how the key pad to the front door is used and make it clear, in each persons care plan, why it is used, how this effects them and steps taken to make sure individuals are not restricted. The manager needs to make sure that everyone is able to wash and dry their hands with suitable products in the laundry, shared bathrooms, toilets and individual bedrooms, where needed. This is to make sure that infections are not spread about. Care Homes for Adults (18-65 years) Page 14 of 34 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Sheila Knopp CPC1, Capital Park Fulbourn Cambridge CB21 5XE 01233 771300 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 15 of 34 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 16 of 34 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can be confident that that they will be given the opportunity to meet people at Dugdale House before they decide if they want to stay. Information will be collected to make sure the staff are able to provide the individual support they need. Evidence: People moving into Dugdale House are offered opportunities to visit and try out the service. Prior to this the manager will carry out an assessment to see if Dugdale House would be suitable and staff can meet their needs, alongside the other people who live there. All the relatives who completed surveys (3) confirmed the needs of residents were always met by the service provided at Dugdale House. They said residents were helped to stay in touch with relatives. One person told us they always feel welcome to visit and their relative appears to be happy and settled when they visit. To make sure people know what to expect from the service and how much they will be charged each person is given a guide to Dugdale House and details of the tenancy agreements. This information is available in a pictorial format. The manager reported Further changes are planned to make the information more individual to each person in the house. Care Homes for Adults (18-65 years) Page 17 of 34 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 . Each person has a plan of care that they have been involved in putting together, with the help of their key worker. This is to make sure they receive support in a way that meets their needs and how they want to live their lives. Evidence: Each person living at Dugdale House has a detailed care plan in place with supporting documents, which set out how any risks are to be managed. The care plans are person centred and had been regularly reviewed and updated. The 2 key workers we interviewed were able to tell us how the plans had been developed with the involvement the individuals concerned. Risk assessments have been put in place to manage different aspects of a persons life inside and outside their home. However staff need to include the restrictions imposed on people because of the addition of a key pad to a door leading out to the front door. A financial profile form has been introduced for each person to describe their involvement with their financial affairs and ability to make decisions in this area of their life. The manager is due to receive more training on the implications of the Mental Capacity Act and demonstrating peoples ability to make decisions in all areas Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: of their lives. This is an area where it is recognised that further development needs to take place as guidance becomes available. Care Homes for Adults (18-65 years) Page 19 of 34 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 are provided with support to take part in activities that reflect their personal preferences and interests. People are involved in planning their meals so they have what they like. However the menu should enable people to choose balanced options each day. Evidence: Each person living at Dugdale House has an individual plan of social care and program of activities. The employment of a driver, who is available five days a week and at weekends by arrangement, enables people to get out and about each day and access leisure facilities within the local community and further away. Arrangements are made for people to spend time away from home at day centres. Volunteer opportunities are being explored for one person. People are involved in activities that contribute to the running of the home such as shopping, preparing meals, housework and personal laundry. Pictures of meals are available to help people choose the meals they want. Staff report Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: the meals are home cooked. We looked at the weekly menu and found that there were areas for improvement. For example describing the meal in more detail rather than pie, not having bacon sandwiches for lunch on the same day that sausages are cooked for dinner, pizza and spaghetti bolognese on the same day, jacket potato for lunch on the same day as vegetable bake. Peoples likes and dislikes are recorded and known to staff. To make sure people have their dietary needs monitored people are weighed regularly and details of their daily food intake are recorded. Care Homes for Adults (18-65 years) Page 21 of 34 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 . People can be confident that their health & personal care needs will be met because there is good access to community health services, each person has a health action plan they have been involved in completing and they are given their prescribed medicines safely. Evidence: Our discussions with staff and review of care records confirmed people are supported to achieve good standards of personal care according to each persons level of independence and need. the care plans include details of how to interpret changes in each persons physical or emotional well-being. As individuals develop conditions associated with older age we have advised that a procedure for the prevention of pressure sores is put in place so staff know what to do and this area of care is regularly reviewed to prevent problems. The people living at Dugdale House have good access to local community health services and attend the doctors surgery as needed. A health care professional told us that the staff are caring towards the residents and treat them with respect, also patience. They said staff always met the health care needs of the residents. Staff were able to provide support to a resident when they had to stay in hospital. A Community Nurse wrote to the manager and said on their visits to hospital they had noted staff advocating on behalf of the resident ensuring they Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: received the best possible care. We reviewed the systems for giving people their medicines and found that regular audits are carried out to make sure people are having the medicines they are prescribed. This a great improvement as previously there have been issues. The managers self assessment tells us that they have reviewed the way medication is recorded and staff are assessed. This has meant a reduction to zero in the number of medication errors.The manager and deputy manager have attended an externally verified certificated course in the administration of medicines and it is planned to extend this to senior staff. We would advise Care Tech to review the facilities for the storage of controlled drugs as, although not currently needed the present arrangements, do not conform to the guidance issued to care home providers. We have advised the manager to get an updated copy of the medicines information book (BNF) as the current copy was issued in 2001 and will be out of date. The managers self assessment (AQAA) tells us that more detailed information about new medicines is being recorded to alert staff to any possible side effects. The manager has identified the need for staff to have training in supporting people with dementia to reflect the changing needs of residents as they get older. The development of care plans and documents in a style more accessible to service users is continuing. Care Homes for Adults (18-65 years) Page 23 of 34 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Dugdale House have opportunities to raise concerns individually with staff, who also look out for signs that indicate people may be unhappy. The people living at Dugdale House are protected because staff are trained in adult protection issues and other key people in their lives are involved in regular reviews of their welfare. Evidence: A relative told us that Dugdale House provides people with a secure, friendly service. People have planned time with their key worker to talk over any issues, feelings or concerns they may have. The area manager for Care Tech makes regular visits and talks with people living in the home. People have detailed annual assessments involving their placing authority, day services and people who support their health needs. These provide further opportunities to make sure people are happy living at Dugdale House. The people able to respond told us they were happy and were relaxed in the company of staff who they looked for to do things for them. Staff are trained in safeguarding adult procedures so they are able to recognise and respond to any signs of abuse. They also receive training in managing challenging behavior without physical intervention. No concerns have been raised between our inspections. The staff we interviewed felt the staff team were positive and worked to promote the interests of the people living at Dugdale House. We have not received any complaints about this service between our inspections. The notifications we receive tell us what action has been taken to remedy any issues that arise as a result of accidents or changes in behavior. Staff liaise appropriately with Care Homes for Adults (18-65 years) Page 24 of 34 Evidence: other services involved in supporting the well-being of residents. The managers self assessment (AQAA) tells us the service has not received any complaints within the last year. Care Homes for Adults (18-65 years) Page 25 of 34 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who live at Dugdale House are provided with a clean comfortable home that they can make their own by adding personal possessions to. Care Tech are due to do some work to make sure everything is up to standard and they need to review the infection control procedures to make sure people can wash their hands effectively when they need to. Evidence: Residents are involved in the running of the home and helping with housework, shopping and their own personal laundry. We looked around the home and gardens during out visit with one of the residents and a member of staff. There are pictures of the residents on the walls as you would have in a family home. Residents have been involved in choosing personal items for their rooms. The kitchen and dining room have been decorated since our last visit. Pictures and ornaments create a homely feel. People are able to lock their rooms and have a locked drawer to put important items in. We found there were areas that need attention due to every day wear and tear. However the manager was able to provide us with details of a recent maintenance audit, carried out by Care Tech on 26/3/09, that covered the areas we had seen. We therefore feel that the quality of peoples accommodation will be updated without us needing to take any further action. General maintenance of the building has included replacing some of the window frames. The Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: television in the lounge is small for the size of room and a relative suggested a bigger screen would be better. We have been told that a bigger television is to be provided as part of the switch over to digital. There are large gardens to the front and rear of the home. These are now regularly maintained by contractors to keep them neat and tidy. there are opportunities for residents to become involved with gardening. The managers self assessment (AQAA) tells us that people grew vegetables last summer. There is small laundry which residents can use. There is no space for a handbasin. Our last report advised the manager to provide a suitable alternative hand cleansing system, for people to use before leaving the room, to reduce the spread of infection. This has not been put in place. Not all the shared bathrooms and toilets had liquid soap or paper hand towels available for people to use. Staff also need access to these products in individual bedrooms when they are providing personal care. Care Homes for Adults (18-65 years) Page 27 of 34 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 can be confident that staff are carefully selected to make sure they are safe. They have regular training to make sure they have the skills they need. Evidence: Three staff are provided to support residents during the day and 2 staff work at night. Care Tech bank staff are used to cover unexpected absences, when the permanent staff are not able to cover this themselves. We looked at the personnel records for 4 staff. This showed us that the required checks on peoples previous employment, references and criminal records checks are carried out before people are employed. A relative told us that the staff are friendly and helpful. The managers self assessment AQAA told us that 57 of staff have National Vocational Qualifications (NVQ) in care practices. Newer staff are completing Learning Disability Qualifications courses (LDQS). We interviewed three of the staff on duty during our visit. They confirmed they were able to discuss things openly with the manager and staff contributed their views at staff meetings. The staff have regular one to one supervision with senior staff so they can discuss their working practices and development. Care Homes for Adults (18-65 years) Page 28 of 34 Evidence: There is a corporate training program in place to make sure staff get the training and regular updates they need. Care Homes for Adults (18-65 years) Page 29 of 34 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 people living at Dugdale House can be confident that their home is well managed and there are systems in place to make sure the quality of their care and safety of the service is kept under review by Care Tech. Evidence: Mr Aumeer has the management qualification (RMA) and is due to complete an NVQ4 care qualification in June. This will complete the standard level of achievement required by managers of care services. A relative told us the manager makes himself available if he is on duty and is very helpful and welcoming.The manager returned the AQAA assessment when we requested it. The information provided has proved to be reliable and sets out further plans for improvement. Care Tech have quality auditing systems in place to review the quality of the service. We saw detailed reports from the area manger, to directors of the organisation, based on monthly visits to Dugdale House. The managers self assessment tells us we also have very well structured recording systems at Dugdale House which enables us to review, monitor and retain accurate up-to-date information. We found this to be the case. Care Homes for Adults (18-65 years) Page 30 of 34 Evidence: Staff confirmed they receive regular supervision. Each resident has their own financial file. This includes details of who is acting as appointee and each individuals capacity to make decisions for themselves. Where Care Tech client services act as appointee a money request form is completed and authorised by managers outside the home. This provides an extra level of accountability and transparency. Financial and accounting details for each resident are checked monthly by the area manager. Daily checks of money held on behalf of residents are carried out to make sure all transactions are accounted for. Staff receive the training they need to promote safe working practices. Safety checks on equipment and safety systems are kept up to date. Care Homes for Adults (18-65 years) Page 31 of 34 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 32 of 34 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 9 Review and record the assessments of capacity for each residents in relation to the implications of having a key pad system, that stops people going out of the front door. Provide people with a more detailed menu that describes the options available and offers them a balanced range of options to choose from each day. We would recommend the introduction of a policy on the prevention of pressure sores so that risk is assessed, recorded and identified at an early stage as peoples health changes. A secure cupboard that complies with the Misuse of Drugs Act and is fixed in the manner described by that act, will be required before controlled drugs are kept in the home. 2 17 3 19 4 19 Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 34 of 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!