Care Home: High Oaks (1)

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What the care home does well "The standard of care is better now than ever before" and "A lovely home, clean and spotless" were what some relatives of people who live in High Oaks told us.People who live in High Oaks can go out and do lots of different things People who live in High Oaks are helped to go on holidays People who live in High Oaks can go to the shops and help with the shopping The people who support people living in High Oaks get the training they need to support them well. People living in High Oaks all have a care plan and know what is in it. They help make sure it is correct and accurate about their goals and hopes for thefuture. What has improved since the last inspection? The manager has been registered and people who work in the home tell us they are a good team. The things we asked the home to do after our last inspection have been done or nearly done. The records of how medication is given have got much better. There has been some workdone to make the home look better. What the care home could do better: People who live in High Oaks tell us that they would like to go out more at weekends. Sometimes the records of how medication is given are still not quite as good as they should be. The home needs to be decorated and some of the furniture needs replacing. There are not enough care staff who work all the time for Walsingham. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: High Oaks (1) 1 High Oaks St. Albans Hertfordshire AL3 6DJ 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: Jeffrey Orange Date: 1 7 0 7 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 35 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 35 Information about the care home Name of care home: Address: High Oaks (1) 1 High Oaks St. Albans Hertfordshire AL3 6DJ 01727844523 01727844523 highoaks@walsingham.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Walsingham Name of registered manager (if applicable) Miss Jane Elizabeth Allen Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: The registered person may provide the following categories 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: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home High Oaks is home to six young adults with a learning disability. It is maintained and managed by Walsingham and is situated in a residential area of St.Albans, Hertfordshire. Each person has their own bedroom and can have their own things in it to make it look like they want it to. There are places where everybody can sit together to watch televison and have their meals if they want to and Care Homes for Adults (18-65 years) Page 5 of 35 there is a kitchen where they can help with the cooking and a laundry where they can help wash their clothes. There are enough bathrooms and toilets for people to use. There is a big garden at the back where people living in the home can sit out and they can also help with gardening and growing things like vegetables if they choose to do so. Information about High Oaks is kept in the home for people to look at if they want to. Care Homes for Adults (18-65 years) Page 6 of 35 It costs about £908 £1198 a week to live at High Oaks. Care Homes for Adults (18-65 years) Page 7 of 35 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 Care Homes for Adults (18-65 years) Page 8 of 35 How we did our inspection: This is what the inspector did when they were at the care home The last time we visited High Oaks was on the 25th July 2008. Where this report says we it means that the inspection was carried out on behalf of the Care Quality Commission (CQC). We gave ten minutes notice before we arrived so that people living in High Oaks could get ready and not be surprised when we rang the doorbell. We also sent some information Page 9 of 35 Care Homes for Adults (18-65 years) to people living in High Oaks before we visited to explain what an inspector is and what they do in an inspection. We were able to speak to at least one person who lives in High Oaks and to observe the care of others. We spoke to care staff and to the homes manager. We looked at some important records to see if they had been completed properly. People who live in High Oaks were helped to fill in surveys telling us what they think about the home and what it is like to live there. Care Homes for Adults (18-65 years) Page 10 of 35 We spoke to other people who visit High Oaks regularly to find out what they think about the home and what they see when they are there. The home sent us a useful document called an annual quality assurance assessment (AQAA) which has all kinds of information in it. What the care home does well The standard of care is better now than ever before and A lovely home, clean and spotless were what some relatives of people who live in High Oaks told us. Care Homes for Adults (18-65 years) Page 11 of 35 People who live in High Oaks can go out and do lots of different things People who live in High Oaks are helped to go on holidays People who live in High Oaks can go to the shops and help with the shopping The people who support people living in High Oaks get the training they need to support them well. People living in High Oaks all have a care plan and know what is in it. They help make sure it is correct and accurate about their goals and hopes for the Care Homes for Adults (18-65 years) Page 12 of 35 future. What has got better from the last inspection The manager has been registered and people who work in the home tell us they are a good team. The things we asked the home to do after our last inspection have been done or nearly done. The records of how medication is given have got much better. There has been some work Care Homes for Adults (18-65 years) Page 13 of 35 done to make the home look better. What the care home could do better People who live in High Oaks tell us that they would like to go out more at weekends. Sometimes the records of how medication is given are still not quite as good as they should be. The home needs to be decorated and some of the furniture needs replacing. There are not enough care staff who work all the time for Walsingham. Care Homes for Adults (18-65 years) Page 14 of 35 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jeffrey Orange 33 Greycoat Street London SW1P 2QF 02079792000 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 15 of 35 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 16 of 35 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 . There is a thorough process of assessment in place to ensure that the needs of anyone considering moving into High Oaks can be met and that they and the people already living in the home will be able to get on with each other. Evidence: We found that there is a very well established group of people living in High Oaks, with no admissions having taken place since our last inspection in July 2008 or indeed since 1999. This means the people who are currently living in the home have not had to adapt to any new person living with them. In their AQAA the home told us that they would go through a full assessment process before any new person was admitted to live in the home and that this process would include the opportunity for people already living in the home to meet the prospective new resident and to form a judgement about them which would be taken into account before an admission was made. This mean that no one should be admitted to High Oaks unless they are satisfied that the home can meet their needs and that they will be happy there and will get on with the people already living in the home. Care Homes for Adults (18-65 years) Page 17 of 35 Evidence: When people living in the home returned surveys to us, they told us that they had been asked if they wanted to move into High Oaks and that they had enough information about the home to help them decide if it was the right place for them. Care Homes for Adults (18-65 years) Page 18 of 35 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 . People living in High Oaks can be assured that they will be encouraged and supported to control their lives to the greatest possible extent. Evidence: When we looked at the care plans of people who live in High Oaks, they included good evidence that they are involved in the planning and review of their care and that they are consulted widely about the routines and organisation of the home. Care plans and other documentation seen were found to include evidence that risks have been assessed and addressed, with a view to supporting people to take reasonable risks in their lives not to limit their lives unreasonably. Where there are currently significant issues involving risks to care staff and people living in High Oaks, these have been identified and risk assessments drawn up, with an enhanced level of behaviour monitoring and recording being put in place. A multiagency approach is being taken to address concerns arising from the patterns of behaviour of some people living in High Oaks in order to ensure the needs of all Care Homes for Adults (18-65 years) Page 19 of 35 Evidence: concerned can be appropriately and safely met in the future. In their AQAA the home indicated that they are looking at ways to make all the documentation even more accessible for the people living in High Oaks. Work has been done to improve the person centred planning documentation and health action plans are now in place for each person living in the home. This means that care staff and the people living in the home can access the information they need to either provide care appropriately or in the case of the people living in High Oaks to be able to get the information they are entitled to in a format that helps them understand it as much as is possible for them. When we received surveys from people living in High Oaks they told us that they always make decisions about what they do each day and that they can do what they want to do during both the day and the evening. In the case of weekends they told us that they cant always do what they want to and that they would like to go out more. When we spoke to the relatives of some of the people living in High Oaks they told us that they were very satisfied with the standard of care they saw. It is a lovely home and The standard of care is better now than ever before were some typical comments. When we talked to a member of the Community Learning Disability Team about their experience of High Oaks, they were again very positive and felt the home met the needs of the people they were responsible for very well. Care Homes for Adults (18-65 years) Page 20 of 35 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 living in High Oaks can be confident that they will be helped to maintain contacts, routines and activities in the home and wider community in line with their personal choices, interests and preferences. Evidence: When we looked at care plans and other associated documentation, we found details of a whole range of activities and groups, outings and social events that different people supported in High Oaks take part in. There was also evidence that where it was in line with the wishes of people living in the home, families and friends were welcome to be part of their lives and the home seeks to strengthen family connections that are important to the people living in High Oaks. When we spoke to relatives of people living in High Oaks they told us that generally they felt they were kept very well informed about issues and concerns if any and that they were very definitely made to feel welcome in the home when they Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: visited. We saw evidence of a programme for development and individualisation of activities, each person living in the home has an individual support plan, with specific goals set by the people themselves, which are then worked toward with the support and help of care staff. The day to day activities of people living in High Oaks are recorded in diaries. People living in High Oaks told us in surveys that they would like to be able to go out more at weekends. When we visited High Oaks we found that some people had gone to day centres, others went out later for lunch or shopping and we found in records that some people routinely spend the weekends with their families. People living in the home are encouraged to develop daily living skills and to follow particular interests that they may have. Care Homes for Adults (18-65 years) Page 22 of 35 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 . People that live in High Oaks can be assured that they will receive care in a way that respects their dignity and rights and that they will have ready access to the healthcare services they need to maintain their health and wellbeing. People living in the home can now be confident that they are adequately protected by the homes medication procedures. Evidence: When we asked people who live in High Oaks if the staff treat them well and if they listen and act on what you say, those who completed surveys said that staff always did. When we looked at care plans and health support plans we found that people living in High Oaks are able to access the healthcare services they need to and that their health was continuing to be monitored to protect and promote their health and wellbeing. When we looked at medication records, we found that there had been some improvements since the last key inspection. There were however still some errors in administering medication, although these had been identified and properly recorded, with one exception where an incident report had not been completed. Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: As carry forward totals for medication balances were not always recorded, it was sometimes difficult to reconcile and audit them. We were told that this would be done in future. Medication seen had been dated on opening and enhanced monitoring had been put in place, which is the principal cause for the improvement found and we were assured that this would continue. Care Homes for Adults (18-65 years) Page 24 of 35 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 live in High Oaks can be assured that they are being protected from abuse by appropriate training being given to the care staff who support them and by the policies and procedures that are not only in place but are being put into practice. Evidence: We have previously found that Walsingham have a comprehensive complaints policy and procedure, which is followed by High Oaks and means that concerns and complaints are treated seriously, properly recorded and followed through. When we looked at care plan documentation and observed how care was being delivered on the day of the inspection visit there was good evidence of people who live in High Oaks being asked for their views and being fully involved in decisions about their care and the operation of the home. In their AQAA the home indicate that they intend to further improve the format of the complaints, compliments and suggestions book to make it more accessible to people who live in the home. This commitment demonstrates that genuine involvement of people who live in the home is being facilitated and that steps are being taken to make that involvement even more meaningful and easy for them to achieve. When we spoke to members of the staff team and looked at training records we saw that safeguarding of people from abuse was included in both induction, routine and update training for all care staff which should provide people living in the home with Care Homes for Adults (18-65 years) Page 25 of 35 Evidence: confidence that the staff who support them are aware of what constitutes abuse and what action to take if it is seen or suspected. Care Homes for Adults (18-65 years) Page 26 of 35 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 . People living in High Oaks can be confident that the home will be kept safe and clean and that physical adaptations will be provided when they are assessed as necessary to meet their changing needs. They can be less confident however that routine redecoration and refurbishment will be carried out in a systematic and timely way to ensure that the standard of the environment remains acceptable. Evidence: When we asked all of the people who live in High Oaks in surveys if the home was fresh and clean, they all responded that it always was. On the day that we visited the home we found that it was essentially clean and reasonably tidy, with no evidence of unpleasant smells. When we looked around the home we found that overall the standard of decor and furnishings is only adequate and there is a need to replace some of the furniture and to redecorate throughout large areas of the home, including individual bedrooms, in order to provide people living in High Oaks with an environment that is appropriate for them. When we discussed this with the manager, we were told that routine redecoration of the home and upgrading furnishings is planned. However there was no definite date for the work and no idea as to its relative priority for Walsingham in relation to other Care Homes for Adults (18-65 years) Page 27 of 35 Evidence: calls on its budgets. This is not satisfactory as people living within social care settings should not be expected to experience significantly different standards of decor or furnishings than would be considered generally acceptable to people not living within social care settings. More positively we found that the scale and layout of the home was pleasantly domestic and homely. Clean and spotless, a lovely home was the comment of one relative that we spoke to. The changing physical needs of people living in the home have been identified and those aids and adaptations that may be needed to support them are said to be being assessed and will be provided in line with those assessments. This should ensure that people with specific environmental needs can continue to live at High Oaks for as long as that is possible and in line with their wishes and best interests. Care Homes for Adults (18-65 years) Page 28 of 35 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in High Oaks cannot be assured that they will always receive support and care from permanent staff. They can be assured that where people are recruited as permanent care staff they are subject to a rigorous recruitment process and that permanent care staff are generally provided with appropriate training. Evidence: When we asked people who live in the home if the staff treated them well, they all responded that they always did. When we asked care staff if there were enough staff to meet the individual needs of all the people living in High Oaks, they all told us that there usually were. In their AQAA the home inform us that none of the permanent care staff have NVQ level 2 although 3 are now working towards it. When we spoke to the care staff on duty they were broadly satisfied with the training being provided, although in some cases they felt that this could be progressed more quickly at area level. There are still approximately 50 of shifts being filled by agency care staff as the recent recruitment drive has not provided sufficient permanent care staff to cover all shifts in the home. Although the agency staff are usually familiar with both the routines of the home and the people who live there, it is disappointing that the Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: situation has not essentially improved since the last inspection. As we were again told that agency staff do not receive supervision or attend staff meetings, it means that on or over 50 of care staff are not receiving direct supervision or being able to contribute formally to team meetings. Although the manager told us that agency staff are encouraged to read team meeting minutes this situation does not help establish a fully integrated staff team and may adversely be affecting the care provided. When we spoke to both social care professionals associated with the home and to relatives of people living in the home they all indicated that they felt the home and the people living in it would benefit from the employment of more permanent care staff. They did however praise the overall quality of all staff providing care and recognised the genuine problems with staff recruitment in the area. When we looked at the records for recently recruited staff we found that a robust system of checks is in place that should provide protection for people living in the home from the employment of unsuitable people to provide their support and care. Care Homes for Adults (18-65 years) Page 30 of 35 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 living in High Oaks and those responsible for them can be assured that it is a well managed home and that the best interests of the people who live there are central to its operation, administration and management. Evidence: When we asked care staff if they receive supervision and support from the manager they all responded in surveys that they often and/or regularly did. When we spoke to care staff on duty on the day of the inspection they were all very positive about the management of the home and said that they felt able to discuss any issues with the manager as they arose. When we spoke to health and social care professionals and relatives of people living in High Oaks they all told us that the manager communicated very well with them and that the manager had significantly improved the service. Standard of care is better now than ever before was one persons assessment. When we looked at care plan documentation we found that it includes appropriate risk Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: assessments and that these are kept under review. For example, where any person living in the home exhibits changes in their behaviour that could adversely affect other people either living in or visiting the home, this is clearly documented and risk assessments and action plans put in place in order to identify risks and to minimise or eliminate them as far as possible. The AQAA was received on time and was adequate in terms of content. When we looked at records kept for the monies spent by staff on behalf of people living in the home we found that it is subject to both internal and external checks and appeared to adequately safeguard the financial interests of people living in the home. In the AQAA we were informed that people living in the home are invited to the Annual General meeting of Walsingham and have input into the homes and the regions business planning process. Their views are canvassed in regular satisfaction surveys and there are also service user meetings and whole life reviews where their views can be obtained and their opinions sought. Care Homes for Adults (18-65 years) Page 32 of 35 Are there any outstanding requirements from the last inspection? Yes  No  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 33 of 35 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 Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 34 of 35 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 35 of 35 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!