Care Home: Elizabeth Peters Residential Care Home

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What the care home does well People living in the home can be assured that their individual needs will be assessed. New people moving to the service benefit from having access to information about the home and are given the opportunity to visit prior to admission. People living in the home are supported to develop their daily living skills and are also enabled to follow their own routine. People receive appropriate health care support. People living in the home are supported in a manner that protects their privacy and dignity. A permanent manager helps the home to run smoothly on a day to day basis. Staff working in the home receive appropriate training. Health and safety measures are in place to safeguard the people living in the home. What has improved since the last inspection? At the time of the last inspection some requirements were made in relation to medication practises and action has been taken to address these. What the care home could do better: Some action is still required in relation to medication practises within the home. Staff need to ensure that all areas of the home used by residents are appropriately heated. Some action is still required in relation to medication practises within the home. Staff need to ensure that all areas of the home used by residents are appropriately heated. Some action is still required in relation to medication practises within the home. Staff need to ensure that all areas of the home used by residents are appropriately heated. Some action is still required in relation to medication practises within the home. Staff need to ensure that all areas of the home used by residents are appropriately heated. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Elizabeth Peters Residential Care Home 22 Newquay Road Catford London SE6 2NS     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: Lorraine Pumford     Date: 0 3 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Elizabeth Peters Residential Care Home 22 Newquay Road Catford London SE6 2NS 02082440013 02082440013 elizabethpeters@elizabethpeters.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Elizabeth Peters Care Homes Limited care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Elizabeth Peters House is a small home for five older people who have mental health problems. The home is one of four owned and managed by a local provider, Elizabeth Peters Care Homes Ltd. The home is in a quiet residential street close to the centre of Catford. The home is well served by public transport facilities with bus and train services within a short walking distance of the home. There is a small parade of shops close by, with larger shops and facilities available in Catford town centre. There were no vacancies on the day of the inspection. The range of fees for a place at the home was not available at the time of writing the draft report. The home makes the reports of the Commission?s inspections available to service users in the hallway of the home. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 5 Care Homes for Adults (18-65 years) Page 5 of 31 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 inspection took place over two days. We met with a number of people who live in the home and with the manager and staff on duty on the days we visited. In addition surveys were sent to staff, residents advocates and health care professionals that meet with people living and working in the home and some of their comments have been included in this report. We looked at the Annual Quality Assurance Assessment AQAA sent in by the provider. This self assessment document focuses on the outcomes for people using the service and plans the provider is making for the future operation of the service over the forth coming months. The last inspection report was also viewed. We looked at what the provider had told us about events that have happened in the service these are called notifications and are a legal requirement. During the time we spent in the home we also examined a number of policies, procedures and documents Care Homes for Adults (18-65 years) Page 6 of 31 and undertook a tour of the buildings. What the care home does well: What has improved since the last inspection? What they could do better: Some action is still required in relation to medication practises within the home. Staff need to ensure that all areas of the home used by residents are appropriately heated. Some action is still required in relation to medication practises within the home. Staff need to ensure that all areas of the home used by residents are appropriately heated. Some action is still required in relation to medication practises within the home. Staff need to ensure that all areas of the home used by residents are appropriately heated. Some action is still required in relation to medication practises within the home. Staff need to ensure that all areas of the home used by residents are appropriately heated. Care Homes for Adults (18-65 years) Page 8 of 31 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 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 10 of 31 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. Standards 1,2,3,4 and 5 were inspected. People using this service experience good outcomes in this area.This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that their individual needs will be assessed. New people moving to the service benefit from having access to information about the home and are given the opportunity to visit prior to admission. Residents benefit from a contract with the provider stating both parties rights and responsibilities. Evidence: The manager stated that they have been no new admissions to the home since the last inspection. The pre admission assessment for one person who had been in the home for over a year, this indicated that a comprehensive assessment had been undertaken which included relevant health and social care professionals. Residents spoken with stated they had been given the opportunity to visit the home pride to admission and people who completed surveys confirmed this has taken place. Care Homes for Adults (18-65 years) Page 11 of 31 Care Homes for Adults (18-65 years) Page 12 of 31 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. Standards,6,7,9,were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home can be confident that they will have an individual care plan and benefit from risk assessments which promote independence whilst minimising the risk to the resident. Evidence: We inspected care plans for two people currently living in the home. We also spoke to care staff about the care plans. The records inspected were clearly laid out and covered all aspects of each persons needs and were written using appropriate language. The care plans had all been reviewed on a monthly basis by the keyworker. Residents have been supported to have an annual care plan review meeting with their care manager. There was evidence one person had been involved in preparing their plan. The second person had chosen not to be involved and had signed their care plan to confirm this. We read the risk assessments for the same two people who live in the Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: home. It was possible to see that staff have identified areas of personal risk and looked at how this can be managed without placing unnecessary restrictions on these people. The risk assessments had been prepared using one main format that was clear and easy to follow. Each resident had a named key worker. Staff were asked about their role as keyworker and showed that the support they provide is very comprehensive including helping with personal shopping, attending healthcare appointments, ensuring all the residents personal care needs were met, organising leisure activities and updating care plans. The staff also showed a good understanding of each residents individual needs. For example one person becomes very anxious when people are in the house that he does not know, staff accompanied us and introduced us at the beginning of the visit to help reduce this persons anxiety. Each person living in the home had behavioural guidelines as part of their individual profile, assessment and care plan and these were clearly written and gave appropriate guidance to the staff. Care Homes for Adults (18-65 years) Page 14 of 31 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. Standards 12, 13,15,16,17 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to develop their daily living skills and are also enabled to follow their own routine. Residents enjoy a range of activities based on their individual interests. Residents benefit from a healthy and varied diet. Evidence: The manager stated that due to the level of their mental health difficulties none of the current residents living in the home attend further education or are in employment. We spoke to the residents, staff and looked at the residents activity programmes to get an understanding about the activities that are taking place. One person told us he Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: did not like to go out very much and enjoyed staying in and watching TV, staff have addressed this in the persons care plan and encourage him to go for short walks with staff around the local area to help encourage a healthier lifestyle for him. Another persons faith is very important to him and staff structure his daily routine to enable him to attend church as frequently as he chooses to. Although people living in the home come and go as they wish and go out without staff support, staff have identified that one person in particular is vulnerable and risk assessments have been put in place to enable him to continue to go out whilst minimising him being taken advantage of by some people in the local community. Staff record in residents daily records activities they have anticipated in during the day. The manager stated that some people living in the home have only limited contact with relatives however, wherever possible staff endeavour to support residents to maintain contact with family and friends. One person spoken with stated that her son visits on a regular basis and she enjoys going out shopping or to other family activities. We met one of the residents in her room which was individually personalised. The resident said she had been able to bring in some of her personal effects from her previous home as well as a number of mementos and she showed us a number of family photographs. Staff stated there is not a written menu however, records seen indicate that staff record meals provided for each person. One person experiences problems around eating and staff have supported him to write his own menu plan. This plan does not include breakfast for five days of the week. Staff stated that this is because the resident may choose to go to out at this time. As staff have completed a risk assessment for the person in relation to nutrition staff must encourage the person to have breakfast either before or after returning home in the morning and must record the food provided. Residents likes and dislikes are taken into account and when we visited residents had been asked what they would like for Christmas dinner this year. All of the people that we spoke with stated they did not have any issues around meals provided. The evening meal was served on one of the days that we visited and this looked appetising and was nutritionally well balanced. Care Homes for Adults (18-65 years) Page 16 of 31 Care Homes for Adults (18-65 years) Page 17 of 31 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. Standards 18, 19, 20 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are supported in a manner that protects their privacy and dignity. Each person benefits from access to professional healthcare input based on their individual needs. Medication procedures help safeguard people in the home, although these could be enhanced further. Evidence: We looked at the healthcare records for two people living in the home. They had all been supported to access a range of healthcare professionals including the GP, psychiatrist and other appointments according to their individual needs. Staff maintain a record of residents healthcare appointments. We looked at the homes medication practices, storage, recording and administration records. Action had been taken to address the requirements made at the time of the previous inspection. We found that all medicines are securely locked. There is a record of all medication received in the home and that medication not administered is returned to the pharmacy for safe disposal. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: In some instances staff had amended the number of tablets recorded on boxes of medicine. The manager stated this had been done as the number of tablets dispensed by the pharmacy did not tally with the number of tablets they had printed on the box of medicine. The manager was advised that the medicine should be returned to the pharmacy immediately to enable them to rectify the error. Some medicines had been handwritten on to the Medication Administration Record and the manager was advised that two members of staff should sign these entries to minimise the risk of an error. We observed during the inspection that staff spoke to residents in a respectful manner. Staff knocked on residents bedroom doors and waited to be invited in before entering. Staff made sure that residents knew we were visiting and formally introduced us to people who chose to speak with us. Residents are able to have the key to their own bedroom if they wish to. Care Homes for Adults (18-65 years) Page 19 of 31 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. Standards 22 and 23 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people living in the home have access to an appropriate complaints procedure. Procedures and training on safeguarding vulnerable adults are in place to help protect the residents. Evidence: The AQAA stated that there have been no written complaints since the last inspection. To date we have received no complaints in relation to this service. People moving into the home are given information about the organisations complaints procedure and people spoken with stated they had not felt the need to make a complaint however felt they could talk to the staff about any concerns they had if they needed to do so. The manager stated that any complaint received would be recorded and prompt action would be taken to address any matters brought to her attention. The manager stated that any complaints made are additionally looked at in terms quality insurance to enable the provider to look at the outcome of complaints to establish if any improvements need to be made to the care and service they provide. No incidents have occurred in the home which have required the service to report the Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: matter to the local authority to be investigated under the joint working safeguarding adults protocol. A copy of the homes safeguarding adults policy is displayed on the wall in the staff room. Care Homes for Adults (18-65 years) Page 21 of 31 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. Standards 24 and 30 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use this service can feel confident they are living in a well maintained home. The home is kept clean and hygienic and is a pleasant environment for the people who live there, however all areas used by residents must be appropriately heated. Evidence: The home is situated in a quiet residential area within walking distance of shops and other amenities. Residents bedrooms are situated on the ground and first floor. There is a considerable variation in bedroom sizes for example the person on the ground floor occupies a very large room with ensuite facilities other peoples rooms vary in size however one bedroom on the first floor is so small that it is not possible to furnish it to the current minimum standards and it is recommended that the provider looks at an alternative use for the room. We talked with the person who occupies the large ground floor bedroom. Although there is a standard radiator in the room which was working the room felt chilly. Discussion took place with the manager regarding the need to find an appropriate way Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: to improve the heating in the room. This room would also benefit from being recarpeted as there is a large burn mark which has been caused by an iron. When we first visited the home the computer used by staff was situated in the residents lounge. The manager stated this was to enable staff to undertake administration as well as be available to residents as the office is on the top floor of the home and not easily accessible to all residents. Discussion took place with the manager regarding the need to move the computer out of residents space and into the office. Discussion also took place regarding the need for staff shifts to take into account staff members administration responsibility as well as care and support to the residents. When we visited the home for the second time action had been taken to address this. Other accommodation consists of a lounge with TV, the dining room is situated in a large conservatory to the rear of the building where there is also a sink and facilities for residents to make their own drinks. The laundry and hazardous substances are stored in a locked shed situated in the garden. Overall the premises are well decorated and maintained and provide a pleasant environment to meet the current residents needs. Care Homes for Adults (18-65 years) Page 23 of 31 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. Standards 32,33,34,35 and 36 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A committed and stable team of staff supports the residents. Residents benefit from staff receiving a range of training and regular supervision sessions which enables them to work to a high standard and deliver good care. Evidence: We checked the rota for the home and this showed that there is a team of eight staff working in the service. The staffing structure consists of the manager and seven carers. During the day there are two staff on duty and at night there is one waking member of staff and one person sleeping in. The staff turnover has been low and there have been no changes to the staff group since the last key inspection. The manager and care staff stated that staff team meetings take place on a monthly basis. The record of these meetings was inspected and it could be seen that they discuss a range of operational issues. The manager stated that she has also introduced a training element in to these meetings. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: The AQAA prepared by the home stated that 99 of staff working in the home have now obtained an NVQ 2 or higher qualification in care. Each member of staff had an individual training record and there is an ongoing programme of training booked until the end of the year covering most mandatory training as well as specific training to support staff to work effectively with the residents they support. The staff said that the training they had received was a good standard and very useful for their work. The manager stated that all staff received more than five days training per year. We looked at the recruitment records for two members of staff. It was found that all the staff had two references, ID, POVA check and a CRB disclosure. The staff had completed and signed contracts of employment. We looked at the supervision records. All the staff had received regular individual supervision. The format used for supervision is appropriate and includes a record of any action agreed. Care Homes for Adults (18-65 years) Page 25 of 31 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. Standards 37,39 and 42 were inspected. People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A permanent manager helps the home to run smoothly on a day-to-day basis. Health and safety measures are in place to safeguard the people living in the home, residents benefit from a quality assurance system that seeks the views of people involved in the service. Evidence: The manager has considerable skill and experience and is currently undertaking the registered managers award. The manager explained that a quality assurance system is in place including regulation 26 monitoring visits undertaken by the provider, In addition the manager completes her own regular audits. We looked at the records of both these and they are completed to a high standard. The company has questionnaires to seek the views of residents, relatives and other care professionals as part of a quality improvement exercise. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: We looked at the fire safety risk assessment and emergency plan and this was complete. The fire alarm and fire extinguishers had been serviced. The fire alarm records show the alarm is checked regularly, fire drills also take place regularly. The AQAA showed that all the health and safety maintenance checks had taken place. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 of 31 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 20 13 The registered person must ensure that errors in the medication supplied to the home are returned to the pharmacy and not amended by staff in the home. To safeguard staff and people living in the home. 27/02/2009 2 24 23 The responsible person must 02/03/2009 ensure that all areas of the home used by residents are appropriately heated. In order to maintain a safe comfortable environment for residents. 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 17 Staff must record that they have encourage the person to have breakfast either before or after returning from theirr morning outing and must record the food provided. It is recommended that two members of staff check and sign hand written entries on MAR sheets to reduce the risk Page 29 of 31 2 20 Care Homes for Adults (18-65 years) of error. 3 24 It is recommended that an alternative use be found for the small bedroom which does not meet the current National Minimum Standards. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 31 of 31 - 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!