Care Home: Grove Road (107-109)

What the care home does well The home presents as having a relaxed and homely atmosphere, and service users have a large degree of control over their daily lives. Service users spoken to expressed satisfaction with the home, with comments such as "I am very satisfied with the care I receive, I am treated with respect and dignity." and "I am satisfied with the care I receive." Service users are able to be active within the local community, and the home is meeting needs around equality and diversity issues, for example cultural and religious needs. The home was generally well maintained, and all service users have their own bedrooms. Food was of a good quality within the home, with a large degree of meals on offer, which help to meet cultural needs. What has improved since the last inspection? There have been improvements to the home since the previous inspection, and the inspector was pleased to note that the overall number of requirements set has fallen from seven at the last inspection to just two at this inspection. Staff have now undertaken training around adult protection issues, and risk assessments are now in place for service users. There have also been improvements made to the policies and procedures and Service Users Guide, and COSHH products are now stored securely. What the care home could do better: A total of two requirements have been made in this report. The home must ensure that care plans are subject to regular review and that they are available to view in the home. The home must ensure that all medications are correctly labeled. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Grove Road (107-109) 107- 109 Grove Road Walthamstow London E17 9BU     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: Robert Cole     Date: 1 5 0 4 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 27 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 27 Information about the care home Name of care home: Address: Grove Road (107-109) 107- 109 Grove Road Walthamstow London E17 9BU 02085206435 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) : bagano98@aol.com Mrs Conchita Damaguen Pooten care home 9 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 9 The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home The home is registered to provide accommodation and support to nine service users with mental health needs. It consists of three homes that have been converted into one. The home is situated in a residential area of Walthamstow in the London Borough of Waltham Forest, and is close to shops and other local amenities, including transport networks. The home is indistinguishable from other homes in the area. The home is privately run. Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place on the 15/04/09, and was unannounced. The inspection included discussions with service users, staff and the homes deputy manager. For part of the inspection the lead inspector was accompanied by three other CQC staff, who were there as part of a social work course assessment. The inspection included an examination of records and other documents, along with a tour of the premises. Prior to this inspection, the home completed an Annual Quality Assurance Assessment (AQAA) at the request of the CQC. The CQC sent out surveys to service users to gain their feedback on the home, six of these were completed and returned to the CQC before the visit to the home. All of this has contributed to the overall inspection process, and to judgements made within this report. Care Homes for Adults (18-65 years) Page 5 of 27 Care Homes for Adults (18-65 years) Page 6 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 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 7 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 8 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. It is the inspectors judgement that prospective service users are provided with sufficient information about the home to enable them to make an informed choice as to move in or not. This information is provided through written documentation, and the opportunity of visiting the home before moving in. Evidence: The home has a Statement of Purpose in place, which is dated and subject to regular review. It states We are committed to providing a secure, happy and comfortable home, promoting a high standard of care and understanding of individual needs, to offer as much support as required, whilst maintaining respect for privacy at all times, and helping maintain personal dignity and independence wherever possible. The Statement also includes a charter of service users rights, these include the right to take risks, and the right to control their own finances. The home also has a Service Users Guide in place, and as with the Statement of Purpose, this is written in plain English. All service users are provided with their own Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: copy of the Guide. The Guide includes details of the manager and staff team, and of the facilities and services provided by the home. In addition to a copy of the Guide, all service users are also provided with a written contract/statement of terms and conditions. These have been signed by the service user and the homes manager. Contracts contain details of the fees charged, and of the services provided. Although there have been no new admissions to the home since the previous inspection, the home has an admissions procedure in place which makes clear that prospective service users would be able to visit the home before moving in, and that an assessment of their needs would be carried out after the home received a referral. There was evidence on service users files that these assessments have been carried out in the past. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the view of the inspector that service users are supported to have control over their daily lives, and that they are involved in the day to day running of the home. However, the home must ensure that care plans are subject to regular review. Evidence: Care plans are in place for all service users, and these are of a generally satisfactory standard. Care plans include a pen picture of the service user, which includes information about their life story. They also cover information around needs related to medication, social and leisure interests and equality and diversity issues such as religion and relationships. Daily logs are also in place which feed in to the care planning process. However, care plans need to be reviewed on a more regular basis. For instance, one care plan was dated the 30/05/08, and stated that it was next due to be reviewed on the 30/11/08, however, there was no evidence that this review (or any subsequent review) has taken place. The deputy manager informed the inspector that she believed that the homes manager had indeed carried out more recent reviews, but Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: these were not available to view in the home by either staff or the inspector on the day of inspection. In order to help ensure that the home is able to meet the changing needs of service users, care plans must be subject to regular review, at least once every six months, and plans should be available to staff to view in the home at all times. Individual risk assessments are in place for all service users.They cover risks around self neglect, mental health issues and accessing the community. Risks are identified, and assessments include strategies for managing and reducing those risks. Assessments make clear that service users are able to take risks. For example, one service user has health issues, and has been strongly advised by their doctor not to smoke, their is a risk assessment in place around this, but the service user is still able to smoke if they choose to. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives. Service users spoken to informed the inspector they are able to get up and go to bed as they choose, and are free to come and go from the home. This was seen to be the case during the course of the inspection, and service users have their own key to the front door. Service users are able to choose what to eat, and mealtimes were seen to be flexible and based around when individuals wanted to eat. One service user commented in their survey that I cook my own food and go to the market to do my own shopping. Service users have the opportunity of been involved in the day to day running of the home. Regular service user meetings are held, minutes are maintained, these evidenced discussions around holidays, activities and meals. The home has a confidentiality policy in place, which makes clear under what circumstances a confidence may be broken in the health, safety and welfare interests of service users and others. Confidential records are stored securely, and staff and service users are able to access their own records. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that service users are supported to live valued and fulfilling lives. Service users are able to be active members of the community, and food was of a good standard in the home. Evidence: No service users are currently in any employment. Service users spoken to informed the inspector that they did not wish to be in employment at this time. One service user attends an adult education class where they study English. Service users attend a social club, which provides the opportunity to maintain and develop friendships. The inspector was impressed by the way the home is meeting service users equality and diversity needs with regards to religion. Service users attend various places of worship, including Mosques and a Greek Orthodox Church. A priest visits the home, as Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: do a group of gospel singers, and service users informed the inspector that they very much enjoyed this. Service users have access to a variety of in-house activities, including satellite television, DVD, music, board games and puzzles and one service user plays the guitar. The home recently got a cat, which service users are responsible for looking after. In the community service users generally are able to attend activities independently, and service users access local cafes, pubs and the bookmakers. Service users are able to access local community facilities, including shops, markets, parks, the library and public transport networks. The home arranges occasional day trips, for example to Southend, and service users are offered a weeks holiday away from the home as part of the basic contract price. This year service users are currently having discussions about where they would like to go. Service users are able to maintain contact with their family and friends, who are able to visit the home at any reasonable time. One service user was recently able to visit their farther in Australia, and another visited their uncle in Glasgow. One service user has family who live in Pakistan, and they informed the inspector that they are able to phone them up every week. Service users are given their own mail to open. Records are maintained of menus, these indicated that service users are offered a varied, balanced and nutritious diet. The home seeks to meet cultural needs around food, for instance one service user eats Halal meat, and they have their own fridge to store this in. Service users are involved in choosing, buying and cooking food. On the day of inspection there was a wide choice of lunches available, two service users had curry, three had a fish meal, while another had sausage and mash. Service users were observed to help themselves to drinks and snacks throughout the day. The kitchen was clean and tidy, and food was stored appropriately. The home tests the fridge and freezer temperatures daily. Care Homes for Adults (18-65 years) Page 14 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. It is the judgement of the inspector that the home is generally meeting the health and social care needs of service users. Service users have access to health care professional as appropriate. Evidence: Care plans make clear that service users are supported to manage their own personal care as much as possible, although staff will offer promoting and encouragement, and advice on dressing appropriately for the weather. The AQAA supplied by the home states that all service users are registered with a GP. Records are maintained of medical appointments, including details of any follow up action necessary. Records indicated that service users have access to health care professionals as appropriate, including CPNs, psychiatrists, dentists and opticians. The home encourages service users to live healthily, for instance through the use of fresh produce in cooking,and supporting service users to take regular exercise. Health related checks such as checking service users weight are carried out. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The home has a medication policy in place, and all staff undertake training before they administer medications. Several service users currently self medicate, and there are checks in place around this. Medications are stored in individual locked cabinets within service users bedrooms. Records are maintained of medications entering the home, and of those that are returned to the pharmacist. Medication Administration Record (MAR) charts are maintained. However, for two service users, the information contained on the MAR charts did not correspond with the information on the dosset boxes used to keep the medication in. For example, one MAR chart stated take DIAZEPAM 5mg tablets 2X a day. The tablets were clearly visible within the dosset box, but the label on the dosset box made no mention of them. To help ensure that service users always take the correct medication as prescribed, it is required that information on MAR charts is consistent with information on dosset boxes, and that both are in line with the prescribing instructions of the medical practitioner who prescribed the medication. Care Homes for Adults (18-65 years) Page 16 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. It is the judgement of the inspector that the home has taken reasonable steps to help ensure service users are safeguarded from the risk of abuse. Appropriate procedures are also in place around making a complaint. Evidence: The home has a complaints procedure in place, all service users are provided with their own copy of this through the Service Users Guide. The procedure includes timescales for responding to any complaints received. The home has a complaints log, which indicated that one complaint has been received since the last inspection. This was from a relative of one of the service user, who said they found it very difficult to get through on the phone at weekends. In response to this the home has had a second phone line installed. The home has a copy of the Local Authorities adult protection procedure, and also its own policy on adult protection. There was evidence that since the last inspection, all staff have now either received training around adult protection, or are due to attend it in the near future. Staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to adult protection issues. Care Homes for Adults (18-65 years) Page 17 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. It is the judgement of the inspector that the home is suitable to meet its stated purpose with regard to its physical environment. The home was generally well maintained, and service users are provided with adequate private and communal space. Evidence: The home consists of three houses converted into one, and is situated in a quiet residential area of Walthamstow in the London Borough of Waltham Forest. The home is in keeping with other homes in the vicinity, and is close to shops, public transport networks and other local amenities. All service users have their own bedroom, five of which are ensuite, and the others all have hand basins installed. All bedrooms had adequate natural light and ventilation. Bedding, carpets and curtains were well maintained and domestic in character. Bedrooms have been able to personalise their rooms, for example with family photographs, and bedrooms meet National Minimum Standards on size requirements. Bedrooms contained adequate furniture including chest of draws, wardrobes and chairs. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: In addition to the five ensuite bedrooms, the home has one toilet/shower room, one toilet/bathroom and one toilet on its own. Bathrooms were clean, tidy and free from offensive odours. All bathrooms have working locks fitted, including an emergency override device. The communal areas of the home consists of three lounges (one a designated smoking room), two kitchen/dining areas and a garden with appropriate garden furniture. Furniture and fittings around the home were generally well maintained and domestic in character. The home has suitable measures in place to help prevent the spread of infection, for example protective clothing is available to staff, and hand washing facilities are situated around the home. The home contract out service users laundry, service users spoken to said they were happy with this arrangement. The inspector was pleased to note that since the last inspection, the home now stores COSHH products securely. Care Homes for Adults (18-65 years) Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that the home is sufficiently well staffed to meet the needs of service users, and that staff have a good understanding of their roles and responsibilities. Evidence: The home provides 24-hour support, including waking night staff. There was a staffing rota on display, this accurately reflected the staffing situation on the day of inspection. All staff are provided with a copy of their job description, and regular staff meetings are held. These are minuted, and all staff are able to contribute to the agenda. Through observation and discussion there was evidence that staff have a good understanding of the collective and individual needs of service users, and that they have built up good relations with service users. Staff were seen to interact with service users in a friendly and respectful manner. Service users spoken to informed the inspector that they are happy with the staff, for instance one commented All the staff here are good. while another said that They are alright here. All staff undertake a structured induction on commencing work at the home, this includes the principles of care and health and safety issues. Of the eight care staff Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: employed at the home, four have achieved an NVQ Level 2 in Care or an equivalent qualification, and the other four are currently working towards such a qualification. It was seen during the course of the inspection that several staff were been assessed as part of the NVQ process. Recent training undertaken by staff includes adult protection, working with adults with mental health issues, care practices and infection control. The AQAA supplied by the home indicates that the home has all necessary employment related policies and procedures in place, including on equal opportunities and recruitment and selection. The inspector checked several staff employment files at random. These were found to contain all required checks, including CRB checks, proof of ID and references. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgement of the inspector that this is a well run home, with appropriate systems in place around quality assurance and health and safety management. Evidence: The homes manager is a Registered Mental health Nurse with over thirty years experience of working with adults with mental health issues, including twenty five years in a managerial capacity. Staff and service users informed the inspector that they found the manager to be approachable and accessible. The AQAA supplied by the home indicates that the home has all relevant policies and procedures in place, in line with National Minimum standards. Those examined by the inspector, including admissions, adult protection and medication were found to be of a satisfactory standard. Record keeping in the home was of a generally good standard. Confidential records are stored securely, and staff and service users can access their records as appropriate. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: Staff and service user meetings contribute to the quality assurance process within the home, and previous inspection reports are available to view. To help gain the views of service users on the care and support provided, the home issues surveys to service users, Completed surveys seen by the inspector contained generally positive feedback. Fire extinguishers were situated around the home, these were last serviced in March 2009. Fire alarms are tested weekly, and were last serviced in July 2008. The last fire drill took place on the 31/03/09, and the home has a fire risk assessment in place. Hot water and fridge/freezer temperatures are regularly checked. The home has in date safety certificates for electrical installation, PAT testing and gas safety. The home has in date employers liability insurance cover in place. Care Homes for Adults (18-65 years) Page 23 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 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person must 30/06/2009 ensure that all care plans are subject to regular review, at least once every six months, and that up to date care plans are available to view in the home at all times. To help ensure that the home is able to meet the changing needs of service users. 2 20 13 The registered person must ensure that any written instructions on MAR charts are consistent with the instructions on the dosset box used to store the medication. To help ensure service users take medication as prescribed. 31/05/2009 Recommendations These recommendations are taken from the best practice described in the National Care Homes for Adults (18-65 years) Page 25 of 27 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 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. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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