Care Home: Greenwood

What the care home does well People are happy staying at Greenwood. Their comments included `the atmosphere is good and people talk to you about anything and everything, no complaints` and `you can say what you want, I like coming here, there`s lots to do and the staff are really nice`. Staff feel the home get `good feedback from service users, they (service users) feel welcome and people listen, complaints are dealt with to improve the service, they (Greenwood) encourage feedback from parents and react well to emergency requests for respite`. The atmosphere is relaxed and inclusive. People are asked their views and involved in decision making. Staff` are enthusiastic and committed to ensuring individuals have a good stay. Effective quality monitoring systems are in place. What has improved since the last inspection? Pictures have been purchased to enhance bedrooms. Greenwood has benefited from refurbishment work. What the care home could do better: Written information for people who may want to use the service or their representatives should be improve so decisions about using the service can be made based on full information. People should be protected by contract of terms and conditions agreed with Greenwood. Recruitment records held at the home should reflect a robust recruitment process is followed to protect people staying at Greenwood. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Greenwood 16 Dalmeny Road Bexhill on Sea East Sussex TN39 4HP     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: Sally Gill     Date: 1 8 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. 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 29 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Greenwood 16 Dalmeny Road Bexhill on Sea East Sussex TN39 4HP 01424210383 01424730470 chris.davies@eastsussex.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : East Sussex County Council care home 16 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 16 The maximum number of service users to be accommodated is 16. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Greenwood is registered to provide accommodation for up to sixteen adults with a learning disability. It is part of services provided by East Sussex Social Services and its purpose is to provide respite (short stays) care. There is a manager who has day-today control although currently not registered with the Commission. The premise is a two storey purpose built unit situated in a residential area. There are eighteen bedrooms all with a wash hand basin and some with over head hoist tracking. People have access to seven bathrooms six of which are assisted or have a walk in shower, two large lounges, a smaller lounge, a dining room and art and craft or quiet room. There is also small kitchen which could be used for independence training. In addition there is an upstairs separate flat with lounge, kitchen/diner, bathroom and bedroom. The home is non-smoking. There is a garden with lawn, patio area and flower bed and Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home also an enclosed courtyard with shrubs. Both areas have seating. The home is suitable for wheelchair access on the ground floor. There is limited parking in the front of the premise and additional on street parking near by. The home is situated approximately 30 minutes walk from the centre of Bexhill and its town centre amenities. Approximately 5 minutes walk from the nearest bus stop, which could take you into Hastings, Eastbourne or Bexhill. The staff compliment consists of two DPS managers (one of which will be the registered manager), duty officers, senior care officers and care officers. Care staff work a rota during the day 7am - 10pm. There are two wake night members of staff and one sleeping in. Fees are based on a financial assessment and people make a contribution although this does not reflect the cost of care. Details of the unit cost per person are available from the manager. Previous inspection reports are available from Greenwood or can be viewed and downloaded from www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 29 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 previous inspection took place on 26th June 2007. This inspection was carried out over a period of time and concluded with an unannounced visit to the service between 09.35am and 5.15pm. The manager was absent and staff assisted during the visit. People that stay at Greenwood and staff were spoken to. Observations were made during the visit. Nine people were staying at Greenwood on the day of the visit. The care of two people was tracked to help gain evidence as to what its like to receive a service from Greenwood. Various records were viewed during the inspection and a part tour of the premises undertaken. Care Homes for Adults (18-65 years) Page 6 of 29 Greenwood sent their annual quality assurance assessment (AQAA) to the Commission within the required timescale. The AQAA is a self-assessment picture of how the manager thinks they are doing against the national minimum standards. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 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 29 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. People who use the service and their representatives do not have written information needed to ensure they are choosing the right service. People can be sure their needs based on their assessment will be met. Evidence: People do not have the full information they need to make an informed choice about using the service. A copy of the most recent statement of purpose and service users guide was examined. The statement of purpose did not contain the majority of the information required by the regulations. A requirement is made in relation to the statement of purpose. The service user guide is in a user friendly format using photographs, pictures and words. This also lacks some information. Staff advised the service user guide is taken by staff when visiting people who want to use the service. Once using Greenwood people are asked twice a year their preferred dates for respite, choice of room and to indicate if they would like their stay to coincide with a friend who also uses Greenwood. This is then accommodated wherever possible. To ensure Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: good communication staff also write an end of stay summery for each individual which includes key events and information to be handed over which the individual then takes home with them. Peoples needs are assessed prior to using the service. All referrals to the service are via their local social services who undertake a full assessment of their needs. Greenwood obtains a copy of this assessment before a person is able to use the service. A visit to the individual in their own home is made to introduce staff and gain any additional information. People have the opportunity to visit and test drive the service. Staff advised that people are encouraged to visit the service prior to a final decision being made. This usually starts with a tea visit where the individual may be accompanied by their social worker or representative and leads up to an overnight stay. People are not protected by contracts of terms and conditions. Two files were examined and neither contained a contract between the individual and the service. A requirement is made. Copies of agreements between the service and funding authority were held on file. Care Homes for Adults (18-65 years) Page 11 of 29 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. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: Peoples needs, wishes and personal goals are reflected in their care plans. The service works closely with families to ensure information in care plans is up to date. Two care plans were examined. These contained good and clear information about at times some very complex changing needs, support and individuals hopes and dreams. One person spoken to confirmed they were aware of their care plan and involved in reviews. A full review is held at the day care service attended by the individual and then an interim review is held at Greenwood. Some review paperwork is in a user friendly format using symbols and words. People are involved in decision making. A residents meeting is held monthly. One had been held the previous evening. Notes made at the meeting on flipchart paper were Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: displayed on the lounge wall. Minutes and discussions confirmed people are able to make decisions including room choice, planned activities and meals. At the end of each stay each person spends time with a staff member where they reflect on their stay, can voice improvements or things they would like to happen on their next stay. Advocacy information is displayed. Any restrictions are detailed in care plan such as a wheelchair harness, listening devises and bed rails. People are supported to take appropriate risks. A variety of risk assessments were in place such as moving and handling and fire. Care Homes for Adults (18-65 years) Page 13 of 29 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 who use the service are able to make choices about their life style. Social, cultural and recreational activities meet individuals expectations. Evidence: People have opportunities to take part in activities and access the community. During the week everyone will continue attend their usual day care service and on their return it was evident these are enjoyed. Records and discussions confirmed in the evenings and weekends people take part in leisure activities and are able to get out and about in the community. Recently these have included trips to Rye, Brighton and Eastbourne, the pub, a football match, the park, clubs and bowling. Photographs are used to give people ideas when choosing what they want to do. Staff advised that people can choose to go to church or in one case arrangements have been set up in house to ensure an individual is able to practice their beliefs. Transport is available and the use Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: of public transport is encouraged. Indoor activities include television, DVDs, draughts, snooker and music. There is an equipped sensory room which people can use. One person talked excitedly about a party being held the next evening to celebrate getting a job as a waiter. To support this the individual has decided to take orders and serve the evening drinks. One person said the best thing about coming to Greenwood was they do lots of things. People are supported to maintain contact with families and friends. Family and friends are welcome to visit anytime. Stays are planned where possible to coincide with friends. People are supported to visit family when staying at Greenwood for longer than the usual respite period. The service is proactive in communicating with families to ensure the best outcome for people staying at Greenwood. In a recent survey undertaken most relatives indicated they were very satisfied others were satisfied with communication between them and the service. Peoples routines are flexible and promote independence. People are offered a key to their bedroom. Staff were observed to interact well with people staying at Greenwood. On return from day care people choose what to do and where to spend their time and this was respected. People are offered varied meals. Staff advised breakfast is cereals and toast. Packed lunches are taken to day care which is chosen each day by the individual. There is a rolling menu for the main meal with alternatives available. A light meal is served at tea time on weekends. Special diets are catered for such as diabetics, allegies and healthy eating. People confirmed that they have input into choosing the menus and that the food is really nice and you can more or less have what you like. Menu planning and todays menu board is aided by photographs and pictures. Care Homes for Adults (18-65 years) Page 15 of 29 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put in practice. Evidence: People receive support in a way that they prefer. A key worker system is in place. During the visit people were treated with respect and their rights to privacy upheld. Equipment is in place to aid independence and meet peoples complex needs such as a variety of assisted baths and showers, over head tracking in bedrooms, bathrooms and toilets for hoists, mobile hoists and standing aids, adjustable beds and wash hand basins. Peoples wishes are recorded in their care plans regarding their preferred morning and evening routines. In a recent survey most relatives indicated they were very satisfied that staff respected people and ensured their dignity, one was satisfied. Peoples healthcare needs are met. Most regular check ups and appointments happen whilst people are not staying at Greenwood such as dentist and optician. People are offerred a health action plan and some have chosen to have these in place. Greenwood Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: liaises closely with health professionals and any advice and guidance is followed through into practice. Any concerns are monitored and referred quickly. People are protected by safe medication systems. Medication storage has been moved into a larger room since the last visit. Storage for medication is safe and secure. Staff advised that the medication policy has recently been reviewed. Robust records and systems for administration are in place including the handover of medication information when respite starts and ends. Staff that administer medications have received training. Some staff have now received training to assess competency of medication administration. There have been some medication errors in recent months however this is a result of staff not following the procedures in place and management action has been taken. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express thier concerns, and have access to a complaints procedure, and are prtected from abuse. Evidence: People feel their views are listened to and any concerns would be dealt with. The East Sussex Adult Social Care complaints procedure is displayed within Greenwood. This is not in a particularly user friendly format which would be good practice. People do have the opportunity to voice any concerns both at residents meetings and during the one to one with staff at the end of their stay. People spoken to said they had no complaints but felt sure if they did someone would sort them. Greenwood has received one complaint since the last visit. This was partially upheld and records have been maintained. The Commission has received no complaints. People are protected from abuse but further staff training could enhance this. The AQAA states that polices and procedures are in place to safeguard people at Greenwood. There have been a number of referrals and safeguarding investigations all of which have been managed appropriately. Records indicated that most staff has received safeguarding training. Good practice would be to train all staff. Staff spoken to show a good knowledge of routes to report any abuse both within Greenwood and outside. Greenwood can hold small amounts of monies for people during their stay. Storage is secure and records robust. Care Homes for Adults (18-65 years) Page 18 of 29 Care Homes for Adults (18-65 years) Page 19 of 29 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. The physical design and layout of the home enables people to stay in a safe, maintained and comfortable environment which encourages independence. Evidence: People stay in a spacious, clean, well-equipped for independence and comfortable home. A part tour of the premise was undertaken. Since the last inspection most bathrooms and a kitchen and lounge area have been refurbished, new lounge furniture and pictures for bedrooms has been purchased, some redecoration has taken place and two new areas have been incorporated into the building one for art and craft and another for storage. Staff advised there are plans to refurbish part of the lounge and the care office, upgrade the call bell system and use one area for assessment and independence training. Staff advised at present the service has been without a handyman for several months which have meant the garden does not look as well cared for as it could, the pictures purchased have not all been put up and some areas could do with a lick of paint. People spoken said their bedrooms were OK. Some bedrooms appeared more homely Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: than others. Management are aware of this and are trying look at ways of improving this. Bathrooms surfaces were all covered with supplies and some notices displayed for staff both which distracted from a homely feel. People have specialist equipment they require to maximise their independence. Most baths are assisted and bathrooms have overhead tracking as do six bedrooms. Some wash hand basins are adjustable in height as are the dining room tables. Greenwood also has several mobile hoists and a standing aid. The home was clean throughout. Care Homes for Adults (18-65 years) Page 21 of 29 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. Staff in the home are trained, skilled, and in sufficient numbers to support the people who use the service and its smooth running. Recruitment records held at Greenwood do not evidence a robust recruitment process is in place. Evidence: People are supported by competent and qualified staff. Records showed that twenty staff have obtained a National Vocational Qualification (NVQ) level 2 or above and another two are currently undertaking it. This is commendable. People spoken to said staff were OK, really nice and they do help me. In a recent survey most relatives indicated they were very satisfied with the quality of staff and one was satisfied. There are a minimum of five staff on duty during the day at weekends and when people are not at their day care service. During day care times there are a minimum of two staff on duty. In addition there are ancillary staff such as cook, cleaners and administrator. A photo board is used so people know who is on duty. Recruitment records do not evidence a robust process is followed to protect people. Original recruitment documents are held at County Hall. The manager has started to collate recruitment information using an Annex 4 form as required by regulation to be Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: held at Greenwood. For one staff member a form could not be found. Forms must be completed by the registered manager who is verifying that the documents/information is in place. A requirement is made for recruitment information to be available at Greenwood. Peoples needs are met by appropriately trained staff. Further training could enhance the staff team. Staff undertake induction training which is to Skills for Care specification. Staff advised this is now on line and it is envisaged that all current staff will complete this. Staff advised that they would also undertake mandatory training within one year. This would include fire, first aid, food hygiene, infection control, moving and handling, medication and safeguarding adults. After this training would be regularly up dated. Records showed that there were some shortfalls across subjects. Further training for first aid and infection control is booked. People benefit from a well supported and supervised team. Staff said they felt well supported. Records confirmed regular supervision takes place and also team meetings. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is run in the best interests of people using it. Effective quality assurance systems are in place. Evidence: People benefit from a well run home. The manager has submitted an application to the Commission to register. She has considerable experience and has worked at Greenwood for several years. She is qualified to NVQ level 4 in management and social care. Staff said she is approachable, good at prioritising and a good communicator and approachable and explains herself. People can be confident their views underpin the development of Greenwood. Individuals have opportunities to express their views about Greenwood. For example at the end of each stay individuals sit with staff and complete a have a good stay questionnaire and have regular residents meetings. Relatives are sent an annual questionnaire. The most recent saw the majority of people feeling very satisfied or satisfied with the service. The organisation also undertakes monthly visits required by Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: legislation. Reports were examined which showed a thorough audit is undertaken with most shortfalls highlighted and followed up at the next visit to ensure action is being taken. It currently lacks evidence that people using the service are involved in the process which would be good practice. The AQAA indicated that health and safety checks and maintenance is carried appropriately. The electrical wiring certificate was not available for inspection on the visit. The date indicates this may no longer be valid. Staff agreed to check this and advise the Commission. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 4 1 The registered person shall 18/07/2009 have a statement of purpose in place in accordance with the regulations, schedule 1 and the National Minimum Standards To ensure people and their representatives have access to comprehensive information 2 5 5 The registered person shall have a written contract of terms and conditions in place in accordance with the regulations and National Minimum Standards with each service user To ensure people and their representatives have access to comprehensive information and are protect by this information 18/07/2009 3 34 17 The registered person shall maintain in the care home the records specified in Schedule 4 18/07/2009 Care Homes for Adults (18-65 years) Page 27 of 29 To ensure service users best interests are safeguarded 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 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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