Care Home: Elmleigh House Care Home

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What the care home does well There were some good examples seen of how people make decisions about their lives, and a risk assessment is carried out when needed. People told us, "Staff ask me what I want to do, I like to go out to the Post Office to spend my money", "I go to the Post Office on my own, I cross a road but its not that busy. My keyworker showed me how to cross a road. I don`t go on busses on my own at the moment, I used to and will do again". People are able to attend a local day centre during the week, which one person told us she enjoyed. There are also courses run in the evenings by a local college which people have taken part in, these include cookery and martial arts courses. People are able to go out into the local community and some people have friendships with other people who live locally. One person went on holiday with a friend. Other people commented, "I stop in at weekends, I watch telly and play on my computer. We have been on holiday this year, I can`t remember where, we all went together", "I go to church every Sunday, and I go to the pub every Friday night and have a coke and prawn cocktail crisps. They do karaoke, I sing Westlife songs". People are able to decide on their own routine and are encouraged to do what they can for themselves, and what they can do with support. One person told us, "I get my own breakfast, I have three Weetabix. I have a bath when I want, I put bubbles in it. I have a lie in at weekends, I go to bed at eight o`clock in the week and later at weekends as I get tired easily". People are helped where needed to look after their hygiene and health. They are given their medication when they need it. We were told, "I need help with washing my hair, I only have a woman help, they do it nicely. I can ask anyone who is on duty for help, I ask things like what is the weather like so I know what to wear" and "I went to the opticians yesterday, my eyes are OK. I feel in good health, I go to well woman check ups at the doctors" People can raise any complaints they have and staff know how to protect them from abuse. We were told, "If I have any complaints I can tell the manager, somebody told me that, but I can`t remember who" and "I feel quite safe, I am not worried about anybody or anything". The home is kept in good repair and some areas are being decorated. One person told us, "Its all right, it`s home. My drawer needed mending and the handyman repaired it. My bedroom is pink, that`s my favourite colour". Staff are provided with the training they need to carry out their duties. What has improved since the last inspection? There is now new paperwork to follow if anyone new wants to come to the home to make sure they are fully assessed. There are now detailed care plans which explain people`s needs and how these are to be met. There is also information about any more complex needs. One person said, "I have a care plan, I said what I used to do with my mum". Another person has asked for a photograph of him in the gym to go in his care plan. Staff only come to work at the home once all the pre employment checks have been carried out. The manager has been overseeing another home but this arrangement has now finished and she is now only responsible for the running of one home. What the care home could do better: People do not get a great deal of variety of food at tea time, with sandwiches being repeated frequently. There are some hot meals provided, one person said, "I like pasta for tea, and I also like pizza, my favourite is pepperoni". There needs to be an assessment of staffing levels, particularly at night time to make sure there are enough staff available to support people as required. Key inspection report Care homes for adults (18-65 years) Name: Address: Elmleigh House Care Home 133 Vernon Road Kirkby in Ashfield Nottinghamshire NG17 8ED     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: Stephen Benson     Date: 0 7 0 7 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 27 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 27 Information about the care home Name of care home: Address: Elmleigh House Care Home 133 Vernon Road Kirkby in Ashfield Nottinghamshire NG17 8ED 01623753837 01623478434 info@elmleighhomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Elmleigh Homes Limited care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Elmleigh Homes Limited is registered to provide accommodation and personal care at 131a; 131b and 133 Elmleigh House Care Home for service users of both sexes who primary needs fall within the following categories and numbers: Learning Disabilities (22) Date of last inspection Brief description of the care home The home currently provides care for up to 22 residents who have learning disabilities. Elmleigh house offers accommodation to residents in 4 separate units situated on the same site. The largest unit has 13 bedrooms, one of these is a shared room. There are then 2 houses which offer 4 places in a domestic style house. The last unit is a one bedroom unit, which has an upstairs bedroom with a kitchenette/lounge on the ground floor. The home sits unobtrusively in a residential street, which is sited close to local shops, transport and other facilities. There is a private car park and a driveway at the property where visitors can park; it is also possible to park on the street. There are pleasant gardens surrounding the property. Information about the home can be found in the managers office and the Manager told us each resident has a copy of the Service User Guide. The latest inspection report is available in the Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 22 2 1 0 1 2 0 0 9 Brief description of the care home managers office. The manager said on 07/07/09 that the fees for the service range from £394.68 to £411.93. Care Homes for Adults (18-65 years) Page 5 of 27 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: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2009. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered since the last inspection. The main method of inspection used is called case tracking which involved looking at the quality of the care received by a number of people living at the home. We also used evidence from our observations; we spoke with them about their experience of Care Homes for Adults (18-65 years) Page 6 of 27 living at the home; we looked at records and talked with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? Care Homes for Adults (18-65 years) Page 8 of 27 There is now new paperwork to follow if anyone new wants to come to the home to make sure they are fully assessed. There are now detailed care plans which explain peoples needs and how these are to be met. There is also information about any more complex needs. One person said, I have a care plan, I said what I used to do with my mum. Another person has asked for a photograph of him in the gym to go in his care plan. Staff only come to work at the home once all the pre employment checks have been carried out. The manager has been overseeing another home but this arrangement has now finished and she is now only responsible for the running of one home. 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 9 of 27 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 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a system in place to ensure anyone new coming to the home will be fully assessed. Evidence: There have not been any new admissions to the home since the last inspection. The manager showed new assessment documentation they have prepared and said this will be used in any future referrals. This is set out to obtain all relevant background information and identify the persons needs. Staff were aware that anyone new coming to the home is assessed first to establish their needs and what support is needed. One person said, I knew someone who lived here, so had visited before, so knew what it is like. Care Homes for Adults (18-65 years) Page 11 of 27 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. Peoples ability to make choices and take risks are promoted through a well thought out care planning process. Evidence: Following the last inspection the home was required to produce an improvement plan, which said A complete new system of care plans have been introduced in order to ensure all service users needs are met in respect of health and welfare. A sample of four care plans were seen which were centred around each person and clearly presented, as well as being regularly reviewed and updated. There were various risk assessments in place, one person had one for accessing the community and another for binge eating. There was information about peoples future plans, one person wanted to learn to cook and wash and iron clothes so she could live more independently. Another person wanted to go on holiday with a friend, which had recently happened. There was also information to guide staff with regard the Mental Capacity Act. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Staff said they read through care plans when they have some spare time and that they find them easy to refer to. One person told us, I have a care plan, I said what I used to do with my mum. One person has decided to start going to a gym and asked a member of staff if they would take a photograph of him in the gym to go in his care plan. There is a section in the care plan called My Day which shows how people have spent their time. One entry seen said one person had caught a taxi to visit her friend. There was a risk assessment completed showing the person was able to catch a taxi independently. Another care plan referred to how another person likes to have their hair done, including the colour it is dyed. One person told us, Staff ask me what I want to do, I like to go out to the Post Office to spend my money. We were also told, I go to the Post Office on my own, I cross a road but its not that busy. My keyworker showed me how to cross a road. I dont go on busses on my own at the moment, I used to and will do again. Care Homes for Adults (18-65 years) Page 13 of 27 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 able to follow a lifestyle that suits their interests and abilities, but have restricted opportunities to have a varied diet. Evidence: Most people living at the home go to a day centre during the week. There is one person who does not attend a day centre and decides what she will do on a daily basis. Another person only goes part time and spends a lot of the remaining time with his family. There are staff on duty in case someone decides they do not wish to go on any given day. One person said, I go to Willow Wood Monday to Friday, I like going there. There are evening courses run in the home by a local college which some people take part in. There were individual learning plans seen and photographs of people taking Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: part in tai chi martial arts class in the garden. The manager said the cookery around the world class had been very popular. Some people have been assessed as being able to go out of the home on their own, others need staff support. People go to places like the local shops and parks, one person likes to go to a fast food restaurant and another goes to visit his girlfriend who lives nearby. One person said, I stop in at weekends, I watch telly and play on my computer. We have been on holiday this year, I cant remember where, we all went together. Another person told us, I go to church every Sunday, and I go to the pub every Friday night and have a coke and prawn cocktail crisps. They do karaoke, I sing Westlife songs. There were a number of people who maintain relationships with people outside of the home, including families and some have boy or girlfriends. People are able to determine their own daily routines, staff said people tend to like to keep to their own set routines and like to do things in a certain order. These will vary between people. There was a weekly planner seen in care files showing different choices people make through the week. There was also a skills analysis showing what people are able to do for themselves, and with support. One person told us, I get my own breakfast, I have three Weetabix. I have a bath when I want, I put bubbles in it. I have a lie in at weekends, I go to bed at eight oclock in the week and later at weekends as I get tired easily. People who attend a day centre are provided with a main meal at lunchtime, and a lighter meal is had in the evening. There is a menu in each of the buildings and these showed sandwiches were frequently provided. There was a list of choices seen in one of the kitchens, however there was little evidence of this being used on a regular basis. The manager said she was aware that this was an area that needed to be addressed and was on her hit list. One person said, I like pasta for tea, and I also like pizza, my favourite is pepperoni. Care Homes for Adults (18-65 years) Page 15 of 27 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. Service users know they will be supported in their health and personal care when needed. Evidence: There are different levels of support provided in each of the buildings, designed to promote peoples independence. One person was being taken to a dentist appointment and was asked if she had cleaned her teeth. The person replied that she had and had been told the previous night and that morning to do so. It stated in her care plan that she requires prompting to clean her teeth. One person said, I need help with washing my hair, I only have a woman help, they do it nicely. I can ask anyone who is on duty for help, I ask things like what is the weather like so I know what to wear. Staff said they had been told about promoting privacy and dignity in their induction when they started to work at the home. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: One person recently had a fall in the home and following this his mobility care plan was reviewed and amended. There were appointments recorded in the care files which showed people have attended well person clinics and had other routine healthcare checks. One person had been prescribed some new glasses and it was recorded when these were collected. Where someone is diagnosed with a health condition such as diabetes or epilepsy, there is information about these included in the care plan. One person told us, I went to the opticians yesterday, my eyes are OK. I feel in good health, I go to well woman check ups at the doctors. One person had been to the doctor and was prescribed some antibiotics. These were seen handwritten onto the Medicine Administration Records and checked by another person that they had been entered properly. The full course of antibiotics was administered. Other Medicine Administration Records seen were fully completed. One person said, I am a diabetic, I take a tablet every morning. Care Homes for Adults (18-65 years) Page 17 of 27 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. Service users would be listened to if they made a complaint and they are protected from abuse. Evidence: There is a complaints procedure in the home which is also produced in a pictorial version. Staff said the complaints procedure had recently been put on the back of peoples bedroom doors. There have not been any complaints made since the last inspection, however following a discussion with the manager and responsible individual they felt that a more proactive approach could be taken to identifying complaints as a measure for improving the services provided. One person told us, If I have any complaints I can tell the manager, somebody told me that, but I cant remember who. There have no been any allegations of abuse or safeguarding investigations since the last inspection. Training on safeguarding has been arranged through a local college and the manager is waiting for them to provide dates for the training. Staff knew how to respond to any allegation of abuse and a new member of staff said she had been told about this in her induction. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: One person said, I feel quite safe, I am not worried about anybody or anything. Care Homes for Adults (18-65 years) Page 19 of 27 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 clean and well maintained. Evidence: We noted in a walk round of the accommodation there were some areas where the decor and furnishings were tired. The manager said she will be carrying out an audit of what needs to be decorated and replaced. One person has recently chosen a new carpet for her room and there was a photograph seen of her doing so. Staff said they thought the layout of the home worked well and people can move freely between the buildings. Any repairs are promptly attended to by a handyman employed in the home. One person told us, Its all right, its home. My drawer needed mending and the handyman repaired it. My bedroom is pink, thats my favourite colour. Staff support people to take part in domestic chores they are assessed as being able to do. Staff commented that they have to collect protective clothing from a central store rather than have a supply in each building. The manager said she expected there to be a supply in each building and she would ensure they are there. Care Homes for Adults (18-65 years) Page 20 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by sufficient trained staff during the day but their needs during the night may go unattended. Evidence: There are usually four staff on duty when people are not at day centres, however there have been occasions when there have only been three staff on duty due to not being able to cover a shortage. There are three staff sleeping in over night, using three of the four buildings. There are some people who have health conditions that may need montitoring during the night and we were told that some people do get up during the night. A recently appointed member of staff said she had sent in an application form and attended an interview before being offered a post, but this was subject to a Criminal Records Bureau check. The member of staff said two references were also sent for before she could start. A check of staff files found the correct recruitment practices were followed. The manager is liaising with Nottinghamshire County Council about some training for staff. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Staff said they had discussed future training in an appraisal meeting held recently. Care Homes for Adults (18-65 years) Page 22 of 27 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. There are suitable management arrangements in the home to ensure the home is run in the best interests of people living there. Evidence: The registered manager has completed a professional qualification (The Registered Managers Award) and takes part in other training provided for staff in the home. The manager had been overseeing another home nearby, however this has now stopped as separate management arrangements have been made. Staff described the manager as approachable and said they felt comfortable to ask any queries. The manager showed some survey forms completed by service users, which made positive comments about the home. Staff said forms had been given out to people asking them what they thought about things in the home and they had answered positively. Comments made had been acted upon, for example one person said he would like a table in his room and one has been provided. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: One person said she had completed a survey form and told us, I go to the residents meetings. The responsible individual said that they had secured the services of a health and safety firm who were going through all the homes health and safety practices. A spot check had been carried out on the kitchen recently and some pots and pans had been moved as a result. There was an emergency evacuation plan seen in care files. One person replied yes when asked if she knew what to do in case of fire. The manager said that all the required health and safety checks and tests are carried out at the required frequency. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 17 15 Ensure service users have 01/09/2009 opportunities to have a varied and wholesome diet This will enable service users to make choices over the food they eat. Current staffing 01/08/2009 arrangements must be reviewed to ensure there is suitable cover provided at all times. This will ensure service users receive appropriate support as required 2 32 18 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 26 of 27 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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