Care Home: Grove House & Grove Lodge

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What the care home does well This small home continues to provide a very individualized caring service for the service users in a homely and safe environment. At previous inspections it was apparent that all the people who use the service are fully involved in making decisions as to the running of their home and that their independence is encouraged and promoted by the staff in a safe manner. There is a stable experienced and very well motivated staff team who interact well with the people who use the service.The staff are enthusiastic about their work and committed to the welfare of the people who live in the home. The staff are well supported with a good standard of training and management. What has improved since the last inspection? Since the last inspection the home has concentrated on improving the care plans into a more person centred format so that the care provided meets the specific needs of each individual in a person centered way. The numbers of staff holding NVQ qualifications has increased since the last inspection and on going staff training continues to be given good priority in the home. The home and garden have benefited from various works of refurbishment, redecoration and the provision of new equipment all these improving the overall appearance and comfort of the home for the service users. What the care home could do better: Improvements should be made to the maintenance of a uniform level of cleanliness in all areas of the home and the routine works of repair and renovation to the home must continue. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Grove House & Grove Lodge 13 & 14 Norton Close Borehamwood Hertfordshire WD6 5DW     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: Patricia House     Date: 0 8 0 6 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 28 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 28 Information about the care home Name of care home: Address: Grove House & Grove Lodge 13 & 14 Norton Close Borehamwood Hertfordshire WD6 5DW 02089536443 02089536443 H3071@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 9 The date of the last inspection of this service was 18/05/2007. Grove House and Grove Lodge, known as numbers 13 and 14 Norton Close, are a pair of semi-detached houses situated at the end of a cul-de-sac in a residential area about one mile from Borehamwood town centre. Each House is self-contained with its own kitchen, dining room, lounge and bathroom but is jointly managed by staff whose office is in Grove house. The home has a shared garden to the rear of the building, accessible via a ramp and which includes raised decking, a patio area with a barbeque and some grass and borders. There are parking bays to the front of the buildings. Grove House accommodates six service users and Grove Lodge accommodates three service users who each have their own single room. The service users residing in the Lodge are more independent than those in the House. However, all current service users are able to make decisions about the running of the home and able to use the Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home transport and leisure facilities available nearby. Although the charity Mencap provides the care services in the home, the building is owned and rented from a Housing Association. The Statement of Purpose, Service Users Guide and latest CQC inspection report for the home are kept in the office and are available on request. A copy of the Service Users Guide, in user-friendly format, is also displayed on the homes notice board. Current fees for the home range from £367.82 to £421.90 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection which took place over six hours on a weekday. This was a key inspection that focused on the key standards of the Care Standards Act 2000 relating to Adults. The report is written using accumulated evidence gathered prior to the inspection including information contained in the AQAA (Annual Quality Assurance Assessment) completed by the manager, information given in any pre-inspection questionnaires and also takes account of statutory notifications sent periodically to the CQC by the home. We made a tour of the building had discussions with the staff on duty and spoke with the homes acting manager by telephone. We met and spoke with a number of the service users. Spot checks were made on a number of the homes records and care plans. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 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 28 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 28 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. Admissions to this service are not agreed until a full needs assessment has been carried out and the home is satisfied that it can meet these needs. People who wish to use this service will be given sufficient information to enable them to make an informed choice about admission. Evidence: There have been no new admissions to the home since the last inspection nor indeed since 2004. It was not therefore possible to examine any recent admission records. However the home has the necessary admission policies and procedures in place and discussions with the staff during this visit evidenced that they understood these procedures and the need for prospective applicants to visit and test drive the home before making any decision about admission. The home has a Service Users Guide and an up to date Statement of Purpose. These standards were met at previous inspections. All the people who currently use the service have a written contract tenancy agreement a copy of which is on their file. Care Homes for Adults (18-65 years) Page 10 of 28 Care Homes for Adults (18-65 years) Page 11 of 28 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. Person centered care plans provide an up to date record of the needs of the people who use the service and of how these should be met. Risk assessments are regularly reviewed to accommodate changing ability need and risk. Evidence: Four care plans were examined and were found to be maintained with good detail with records being up to date and to show how changes had been made to meet the changing needs of the service users. Each section of their plan which was written in a person centered way was seen to be signed by the service user this evidencing their involvement with the compiling of the plan. The staff explained that they had all received training in Person Centered Planning and continually worked with the residents to complete and update these. Residents spoken with said that they were fully involved with their plans and in determining their own personal goal setting. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: In all cases a wide range of individual risk assessments had been completed. The residents who go out from the home independently have risk assessments to cover this activity and often mobile phone checks are made to confirm their safety. During this visit one resident who had reached their destination rang to home to let staff know that they had safely arrived. The records for the service users who have epilepsy had recently been updated and staff showed a good awareness of the quickly changing needs of one resident whose health had fluctuated over recent months. Evidence could be seen of the appropriate involvement of epilepsy specialist services to monitor these changes and to offer the appropriate care. During this visit it was seen that service users information was kept securely in the office and that staff had a good awareness of keeping this information confidential. All the service users spoken with confirmed that they are fully involved with choosing their own life style they said that staff involve them fully with the running of the house and always consult them about changes and that they are always supported to make decisions about their daily life. Care Homes for Adults (18-65 years) Page 13 of 28 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. The people who use this service participate in a range of activities based on their individual needs and choices and they are supported appropriately by staff to use local community facilities and to maintain family and community links. They are encouraged to make their own decisions about a choice of meals which provides a healthy and varied diet. Evidence: All the service users have an individually planned day activity programme encompassing several weekdays as well as some regular weekend and evening activities. Most attend Day Centres but clubs and educational classes are also attended. One of the older service users has retired from the day centre and has at their request a less active programme whilst more engaging classes have been found for others who are still able to be much more active. One resident who is a member of Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: a local choral society had recently participated in their concert and they along with some other service users also enjoy the productions of a local drama group. All the service users take holidays; last June they chose to go together as a group to Paris and photographic evidence of this very successful first holiday of all the home residents was shown to us during this visit. This summer it is planned that individual holidays will again be taken and small parties of one or two friends will stay at a number of locations of their choice including the Isle of White. Records from a residents meeting in June evidenced that plans for day outings to Littlehampton,Bury St Edmunds ,Southend and Whitstable are planned for the coming summer months. The staff assist all the residents to maintain contact with family and friends. Records showed that family visitors to the home often stay quite late and several residents make regular staying visits to their parents home and join in with family holidays. One resident told us that they were looking forward to going to stay with their parent when they celebrate a major birthday. Procedures in the home ensure that residents are helped to make decisions about their daily lives for example they choose what time to go to bed and what they will eat. Staff told us of the recent assistance given to one service user to enable them to cast their vote and the particular help that is given to another resident with poor sight to ensure that they have a full and interesting life style. Information on the AQAA told us that all the people who live at the Groves now have a bus pass and some have been trained and have the confidence to use public transport independently. The home decides on a weekly menu which was seen to be listed on the kitchen wall. These choices then effect the shopping which was being carried out on the day of our visit. In the afternoon when they returned from their day activities several of the residents told us of the menu variations they had chosen for themselves. The three residents who live in the lodge are assisted to plan their own menu and are given any assistance they need with the preparation of their meals. Care Homes for Adults (18-65 years) Page 15 of 28 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 and they are treated with respect and dignity. Evidence: During this visit we saw that service users were being supported by staff in a very respectful manner and that personal care was delivered to them in the manner that they choose. One service user who was unwell on the day of our visit was heard to be consulted as to if they required help with their morning bathing routine and whether or not the doctor should be consulted. Service user records seen had visits to and from doctors and hospitals clearly documented. Staff said that they had a built up good liaison relations with their local GPs who were knowledgeable about learning difficulty conditions and who always responded promptly and would refer for specialist assistance whenever it was required. The care plans contain a section called My Health Plan, service users were familiar with these and told us that they contributed to them on a regular basis. The home continues to use a monitored dosage system MDS for the storage and Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: administration of medication. All the staff have attended medication training and the MAR ( medication administration record ) sheets were seen to be completed properly. The home stores its medication in a wall hung purpose designed medication cabinet in the office which combines also as the staff sleep over room.This small office is very crowded and gives no space or clear working surfaces on which to prepare medication to be administered. Any medication requiring a fridge is put in a marked metal container in the main food fridge in the kitchen. The home does not have a Controlled medication cabinet or register. We spoke with the manager about the need for this to be provided and about the generally cramped location of the medication storage area which could impede the safe administration practice. There were records and risk assessments in place for medication held at the day centre and for a resident who handles some of their own medication. Care Homes for Adults (18-65 years) Page 17 of 28 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 this service are able to express their concerns, have access to an effective complaints procedure and they are protected from abuse. Evidence: The homes Complaints and Whistle Blowing policy and procedures are displayed on the notice board and service users asked had a clear awareness of how to make a complaint and said that they would not hesitate to do so if they felt something was wrong. One even mentioned an earlier time when they had expressed a complaint on behalf of several of their peers and how this had resulted in improvements being made for them all. Staff told us that all the service users have a complaints letter and a pre paid envelope which they can use if they wish to make a complaint. There have been no complaints made since the last inspection. All the staff have attended training on the protection of adults and staff spoken with showed a good awareness of their roles and responsibilities in protecting such vulnerable service users and of how and when they may need to make notification to the local authority safeguarding team and to the Care Quality Commission. There have been no incidents concerning adult protection since the last inspection. The home keeps the Care Quality Commission informed of changes and other management matters and a recent staff disciplinary incident was seen to have been handled properly and promptly this to ensure the full safety for the service users. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: The manager and some senior staff have attended training concerning the Mental Capacity Act and the Deprivation of Liberties. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe and comfortable environment which encourages their independence. Up keep of the building is generally adequate but better attention should be given to the maintenance of an adequate standard of cleanliness in all areas of the home. Evidence: Grove House and Grove Lodge are a pair of semi-detched houses situated at the end of a cul-de-sac in a residential area about one mile from the town centre of Borhamwood. Each house is self contained with its own kitchen, dining room, lounge and bathroom but is jointly managed by staff whose office is in Grove House. The laundry facilities and the garden are shared by both houses. Grove House accommodates six persons and Grove Lodge three. All have single bedrooms and these rooms were seen to be personalised to meet individual tastes and reflect personal interests and to be equipped with facilities that meet their individually assessed needs. One room has special lighting to assist the poor sight of one service user and staff explained that plans are being made to provide another room with its own en-suite facilities to better accommodate the needs of another service user. Since the last inspection a number of rooms have been redecorated and some furnishings and new carpeting provided. Works to replace the kitchen floor in the Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Lodge were to commence on the day following this visit. Staff explained that recently much time had been spent in working on the overgrown garden which was found at the time of this visit to provide suitable space for recreation and a patio area where BBQs can be enjoyed. The garden is quite large and clearly requires regular maintenance which is beyond the abilities of the staff and service users to effect an ongoing satisfactory standard; the home should consider employing some regular maintenance hours particularly during the growing season. Several of the boundary security panels were broken and needed to be replaced to ensure the safety of the service users. The standards of cleanliness in the home were found to be very variable with some areas in the House looking fresh clean and tidy whilst all the communal areas of the Lodge the kitchen, toilets and bath rooms had a dirty unkempt appearance. Staff explained that service users are expected to keep their own areas clean and staff do try to assist them with this. However it was difficult for staff to maintain standards as care needs always had to take priority and the part time cleaner who used to work the home left some time ago and had not been replaced. Information given to us by the acting manager in the AQAA confirmed his awareness of this situation and the need for regular cleaning time beyound what the existing staff could provide. The AQAA also mentioned the benefit that the service users would gain from appropriate infection control training which could be done with in the service. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from receiving support from a consistent and well trained group of staff who know them and understand their care needs very well. The homes recruitment procedures are robust and ensure that residents are protected from abuse. Evidence: The service users spoken with all felt that they were well supported by the staff and that generally there were sufficient staff on duty to enable all their needs to be met. Service users spoke of the staff helping them both inside the home and accompanying them on journeys outside of the home. One person with deteriorating eye sight now has a volunteer who takes them out and others spoke of the enjoyable regular shopping trips that staff take them on at weekends. All the staff spoken with however felt that to meet the increasing needs of some of the older service users extra staff hours were needed particularly at night and over the early morning periods. They also felt that for other service users who have personal goals to achieve a better level of independence would benefit from more individual staff input with such aspects as cooking and cleaning duties. Information given to us by the manager on the AQAA indicated an awareness of this and said that the staff complement would be kept under review especially as the needs of the service users Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: change over time. The home is fortunate in being able to retain a stable care team who are all well qualified and experienced at working with this client group. During this visit it was seen that staff work very well together as a team and clearly have meeting the needs of the service users as their top priority. Care Homes for Adults (18-65 years) Page 23 of 28 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. People who use this service benefit from living in a well run home where their views are listened to and acted on and where the welfare of both residents and staff are promoted. Evidence: Since the last inspection the registered manager left suddenly and for the past three months the home has been run by an acting manager from another mencap service who had the benefit of previously knowing many of the service users very well. A new manager has now been appointed and is to take up duties at the beginning of July. Service users told us that the acting manager was very good easy to talk to and approachable, as were all the other staff most of whom had worked at the home for many years. The staff spoken with confirmed that they had been well supported through the recent management changes and the acting manager and the area manager had spent time in the home which had ensured that the service delivery continued smoothly so as to meet all the service users needs. Staff confirmed that they received regular supervision and the minutes of staff and residents meetings Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: evidenced that these were planned and regularly held with good participation to each. The home compiles an annual training needs plan and it could be seen that the individual training requirements of all staff had been incorporated into this. Staff spoken with confirmed that training is given good priority in the home.All the care staff hold NVQ qualifications at either levels 2 or 3. The service has a Quality Assurance programme which is initiated by the mencap head office who send questionnaires to the residents, relatives, staff and other professional stakeholders in the service. The home gives good priority to promoting the health safety and welfare of the residents and staff through the regular maintenance of safety checks, training and record keeping. The records relating to fire testing and the monitoring of water temperatures were found to be regularly completed along with risk assessments for the environment. Service users spoken with had a good awareness of the need for regular fire drills and bell tests even if they did at times find these very annoying interruptions. Records of accidents and incidents were also seen to be well documented. Care Homes for Adults (18-65 years) Page 25 of 28 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 28 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 1 20 It is recommended that the home has a Controlled Medication cupboard so as to fully meet the requirements of the Medicines Act and that the location of the medication storage facilities are reviewed so as to ensure safety for the service users at all times. Care Homes for Adults (18-65 years) Page 27 of 28 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. 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