Care Home: Gatooma

What the care home does well Gatooma is a comfortable and homely place to live. People get the chance to visit the home before they decide to move in. The home makes sure it can meet their needs before they move in. There are good plans so that staff know what people need and how to support them. People can make choices about what they want to do each day. There is good support for people to join in activities in the local community. They also have the chance to do new things and develop their skills and interests. The home helps people to stay healthy People`s complaints are taken seriously. Staff know how to keep people safe and protect them from abuse Staff are well trained and supported to do their work. They know what help each person needs. Managers make sure the home is run for the benefit of people who live there. What the care home could do better: We have not made any requirements or recommendations as a result of this visit. Key inspection report Care homes for adults (18-65 years) Name: Address: Gatooma Brandis Corner Holsworthy Devon EX22 7YD     The quality rating for this care home is:   three star excellent 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: Graham Thomas     Date: 1 1 1 2 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: Gatooma Brandis Corner Holsworthy Devon EX22 7YD 01409281778 01409281764 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Atlas Project Team Ltd care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Age range 18 - 65 Category of Learning Disability (LD) Date of last inspection Brief description of the care home Gatooma is a care home providing personal care and accommodation for up to five people aged 18 - 65, with learning disabilities whose behaviour may challenge services. It is owned by the Atlas Project Team Limited who also own several other care homes in Devon, Berkshire and Surrey. Gatooma is in a rural setting on the edge of the small hamlet of Brandis Corner. The nearest amenities, such as shops and post offices are approximately five miles away in neighbouring towns and villages. Therefore, the home provides transport for people using the service. The home is comprised of a two-storey detached house with a two storey extension (the annexe). The the first floor is divided and can be accessed by separate staircases at each end of the building. All the homes bedrooms are single and one has an en-suite bath and toilet. In the main house there are two shower rooms with toilets. In the annex two people share a bathroom but there is an additional toilet on the ground floor. There is Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 5 Brief description of the care home ample communal space including a separate lounge, dining and garden rooms. The home has extensive gardens and grounds including an indoor heated swimming pool. All areas are accessible to the people living in the home. Current fees range from £2,134 to £2,782 Additional charges are made for hairdressing, toiletries and some activities, such as the cinema. The most recent inspection report is available on request. 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: three star excellent 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: We looked at our records about Gatooma before we visited. We checked if there had been any complaints and information the home had sent us called notifications. Before our visit the home returned an Annual Quality Assurance Assessment (AQAA) which we reviewed. We also looked at surveys completed by staff and people living in the home While we were there we looked around to check if the home was a safe and comfortable for people Two peoples care plans told us what people needed. We spoke with staff and looked at what was going on to check if they were getting the right support. We looked at staff records to make sure that the right checks were made to keep people safe. We also spoke with staff about their work and the training they had. Managers spoke with us and we looked at records to check whether the home was run Care Homes for Adults (18-65 years) Page 6 of 27 for peoples benefit. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 2 People considering a move to Gatooma can feel assured that the home will make sure it can meet their needs before offering a place. Evidence: In the Annual Quality Assurance Assessment (AQAA) completed and returned to us before our visit, the home told us; Newly admitted service users are fully involved in their admission, given lots of opportunity to find out about the home, the people and what their life would be like there. Their needs are fully assessed and understood before they are admitted. The organisation have policies and procedures in place which provide comprehensive guidance to ensure that a thorough assessment of needs is undertaken prior to a place being offered to a new service user........During the admission of one service user it was felt necessary for the individuals transition to take place over a period of a couple of months. It started with a couple of day visits and then progressed to a couple of over night stays. The service user felt more comfortable with this approach and enabled them to move in a more structured process which met the needs of the individual. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: We looked at individual records about peoples admission to the home and discussed these with staff. We also spoke with people living in the home about moving in. This confirmed that there is a sound procedure in place that enables people or their representatives to make an informed decision about moving to the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 6, 7 and 9 Gatooma has excellent systems in place to meet peoples individual needs and support them to make choices about how they live. Evidence: We looked at the files of two people living at Gatooma. Each contained detailed guidance for staff about the persons individual needs and how these were to be met. For example, one plan provided guidance for staff on how one person was to be supported in managing their personal hygiene during menstruation. Another, showed how one person was being encouraged and supported to manage an eating related disorder by promoting good diet and exercise. Regular monitoring of the persons weight and blood sugar levels showed a substantial fall to more healthy levels. The plans and discussion with staff and people using the service also demonstrated how the staff were working with families to manage potentially challenging behaviour. Each persons plan contained a detailed set of individual risk assessments relating to Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: routine activities such as car travel, activities in the community as well as other specific physical interventions. These provided staff with clear and specific guidance on the risks, their management and why taking these managed risks was important for the individual. Staff had signed these assessments to demonstrate that they understood and agreed with them. We saw that the homes approach to risk and its assessment supported individual development by offering a wide range of opportunities based on individual need and interest. The care plans and risk assessments showed evidence of review and adjustment according to ongoing assessment and changing needs. For example, following one persons dental treatment a detailed guidance had been put in place regarding support and encouragement for the person to clean their teeth. This was seen being carried out during our visit. Our discussions with staff and observations of their work showed that they clearly understood each persons needs and how to meet them. 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 excellent 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 and 17 People living at Gatooma are very well supported to make choices about their lifestyle. Evidence: Before our visit, the home told us in their AQAA, Service users are encouraged to develop their personal skills and knowledge. Service users receive development incentives for additional activity; it would demonstrate a value on what has been achieved. There are excellent opportunities for hobbies and interests. These currently include yoga, water aerobics, walking, cycling, trips to the cinema and local bowling alley. Individual holidays are being organised and all the service users are actively involved in the organisation of this. Outings for work and leisure are a normal feature of life at the home. Service users take turns to choose the menu for a week. The fridges and freezers are kept well stocked. Fresh fruit is available. The standard of food is good and appropriate to the age and needs of the service users. Each service Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: user has an individually tailored programme of activities some of which are planned and regular such as cooking. Staff provide stimulation through teaching essential life skills, arts and crafts and game sessions. Spontaneous activities also occur such as pub and cinema trips, rambling and sports. All service users are able to attend at least one annual holiday each year which will meet their individual needs. All activities are designed to take account of service users educational and recreational needs and are provided both within the home and outside to ensure participation in the community. We looked at care plans and risk assessments and spoke with people using the service. All confirmed that people are supported through individual plans to pursue their own hobbies and interests. One person left the home to go horse riding while we were visiting. One person told us about attendance at a college art course and took pride in showing us work they had completed which was displayed in the home. As well as community based activities, the home has a day centre on site. We visited this centre and saw examples of activities that people had been involved in and discussed these with staff and people living in the home. The range of activities available in the home included, for example woodwork, art and gardening. During our visit we saw people being supported to follow their own routines. We also heard how people participated in menu planning and other areas of decision making and the running of the home. For example, one person regularly assists staff to carry out routine fire checks. Staff and people living in the home told us about the contact they have with their families. This was identified in individual plans that also showed how the home was working with families to support the management of peoples challenging behaviours. We saw that there was plenty of food in the home including fresh fruit and vegetables. Particular dietary requirements and preferences were identified in peoples care plans. Meals are planned with staff on a weekly basis based on the choices and preferences of people living in the home. The meals actually taken were recorded in a diary. We joined staff and people living in the home for a lunchtime meal. This was a congenial occasion in which people living in the home were supported and encouraged to join in the conversation. During the meal we saw that one person was following a diet that accorded to their care plan and individual need. 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. Standards 18, 19 and 20 People living at Gatooma receive good, individualised personal support and health care. Evidence: We looked at the personal support received by people living in the home. Peoples individual plans of care set out detailed information for carers about the persons personal support needs and how to meet them. One persons plan gave detailed information the support they were to receive in maintaining personal hygiene during menstruation. We also saw one person being prompted to clean their teeth in accordance with needs set out in their plan. In peoples plans we saw evidence of regular health care checks such as dental and eye checks as well as more specialist treatments. There was evidence of review and the involvement of external professionals such as mental health professionals. We saw in one instance the a person had a particular disorder associated with eating. The persons diet and weight had been monitored regularly and they had been encouraged to participate in a variety physical activities. The approach was imaginative and Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: tailored to the persons individual need. The regular monitoring showed reductions in blood sugar and weight. We saw that medication in the home is securely stored with additional security and recording for controlled drugs though none was in use at the time of our visit. Staff training records showed that staff administering medicines had received appropriate training. Medicines are supplied from the pharmacy in individual containers. The medicines are then transferred to individual packs by the homes staff. This practice is known as secondary dispensing and does not accord with the best practice recommended by the Royal Pharmaceutical Society. However, we saw that the home had robust checking systems to ensure that any errors could be identified immediately. We saw that there had been no medication errors and were satisfied that the system in place was sufficiently safe. 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. Standards 22 and 23 People living at Gatooma can be assured that complaints would be taken seriously and dealt with properly. They are protected from abuse through the strong leadership culture of the service. Evidence: Examination of our own records before our visit showed that the Care Quality Commission has not received any complaints about the home. We saw that the home does have a complaints procedure in place which is accessible to people using the service and a system to record any such complaints. These records showed that the home had received no complaints since our last inspection. We saw that people using the service were very relaxed in the presence of staff. The senior management of the service has a very robust approach to the protection of people from abuse. This was reflected in our discussion with senior managers and staff about safeguarding and staff disciplinary procedures. Our discussions with individual staff confirmed that they had received training in safeguarding vulnerable adults from abuse. Each staff member was able to identify clearly how they would report any abuse suspected or witnessed and what their expectations would be. Care Homes for Adults (18-65 years) Page 18 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. Standards 24 and 30 People living at Gatooma enjoy a comfortable, well-maintained environment suited to their individual needs and preferences. Evidence: Gatooma is in a rural setting on the edge of the small hamlet of Brandis Corner. The nearest amenities, such as shops and post offices are approximately five miles away in neighbouring towns and villages. Therefore, the home provides transport for people using the service. The home is comprised of a two-storey detached house with a two storey extension (the annexe). The the first floor is divided and can be accessed by separate staircases at each end of the building. All the homes bedrooms are single and one has an en suite bath and toilet. In the main house there are two shower rooms with toilets. In the annex two people share a bathroom but there is an additional toilet on the ground floor. There is ample communal space including a separate lounge, dining and garden rooms. The home has extensive gardens and grounds including an indoor heated swimming pool. All areas are accessible to the people living in the home. We toured the home and found all areas to be clean, well decorated and generally furnished to a high standard. One stair carpet was showing signs of wear and was due Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: for replacement. The manager was aware of this and it was planned that this would be replaced in the near future. People told us that they liked their rooms. In their rooms we saw many personal possessions and ornaments. The rooms were individually decorated according to the tastes of people living in the home The home has two laundry facilities, both of which were maintained in a hygienic condition. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 32, 34 and 35 People living at Gatooma are very well supported by an enthusiastic, well trained and supported staff group. Evidence: We looked at a sample of staff files, spoke with staff members and observed their interactions with people living in the home. Our observations when visiting the home confirmed that staff had a very positive attitude. Staff displayed a relaxed and supportive relationship with people living in the home. In conversation, they had a very clear understanding of their roles, responsibilities and the needs of the individuals they were supporting. We looked at the file of a recently recruited staff member and spoke with the person. This confirmed that there was a robust recruitment procedure in place including a formal application, references and criminal records checks before the person started work in the home. These checks are repeated every three years. The staff member confirmed that they were receiving a structured induction which includes staged reviews at one week, one month, three months and so on. We also saw their induction pack. This staff member described the support received during this period as being excellent and explained that they always felt able to ask questions of Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: colleagues and would always be helped to work through any difficulties. The staff member also told us about staff meetings, describing these as really helpful. These focus on the individual needs of people living in the home. Training records were seen and training was discussed with individual staff members. This confirmed that people were receiving training in health and safety topics such as food hygiene and first aid. There was also training related to the particular needs of people living in the home. For example, all staff receive SCIP training about interventions when peoples behaviour challenges the service. A senior member of staff who came to the home during our visit, told us how this particular training was being reviewed to ensure it met the needs of the home and people living there. A programme of training for National Vocational Qualifications (NVQ) was also in place. 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 excellent 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 Gatooma is very well managed for the benefit of people living there. Evidence: During our visit to the home, the Registered Manager was on sick leave. She nonetheless came to the home to speak with us during the course of our visit. We also met with an assistant manager and a senior member of the organisations management team. The manager has completed the registered Managers Award and has worked at Gatooma for five years. Atlas Project Team Ltd has a trainee management scheme. At the time of our visit, two staff were being trained under this scheme. Management training includes such areas as disciplinary procedures, interviewing skills and training regarding costings. During the visit we saw an evaluation of this training programme which was clear and well structured. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: In our discussions with staff and the management team it was apparent that everyone was very clear about their roles and responsibilities and that management support for staff was of a high standard. One staff member told us that the support they received was fantastic and that they had plenty of opportunity to reflect on their practice and gain advice. The registered manager confirmed that the directors of the company visited the home regularly and that there was always a member of the management team on call if they were not immediately available. The records we saw were generally very well maintained and provided guidance for staff that was clear and easy to follow. Regular meetings are held with staff and the needs views of people living in the home appeared paramount in the ethos and practices we have described in the previous sections of the report. We saw evidence that regular visits to the home are conducted by the Responsible Individual as required by regulation. These form part of the homes system for monitoring the quality of the service provided. A quality assurance checklist is used by the service with key quality indicators based on the needs of the people living in the home. We saw that health and safety issues were being well managed. For example, we saw environmental risk assessments and records concerning maintenance of the gas and electrical systems in the home. 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 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). 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