Care Home: High Trees Care Home

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What the care home does well People using the service are supported by dedicated management and staff to experience a full and active lifestyle. People are encouraged to pursue independence internally and externally to the service. The service provides space for the people using the service to access all parts freely, their accommodation is comfortable, warm with homely touches. The service demonstrates its commitment to the people and the support they may required by involving people using the service in the recruitment and interview process. We evidenced the feedback from the staff and people using the service from the surveys they had completed. The service extends the method for feedback about the service by having Quality Review groups, these groups include families and friends. The service had an experience management team that ensured that the service moves forward, while meeting and supporting the peoples needs What has improved since the last inspection? All the people using the service have an essential life plan. The ground floor has been extensively refurbished. A bathroom on the ground floor has been refurbished. Three bedrooms have been refurbished incorporating an en-suite facility. Ramps have been erected to the front and back door. A conservatory has been erected, decorated and furnished. Information for the people living using the service had been provided with user friendly documents. Staff have attended training on non-mandatory topics. A new fire system that complies with all the new legislation has been installed. The management posts have increased since the last inspection. What the care home could do better: To confirm in writing the placement, following the assessment to meet the needs of the person.To include within the required documents the current fees for the service including any top up arrangements. To consider an alternative format for the Statement of Purpose and service users guide, this would enable people using the services to understand what the service offers. To update the details of the Care Quality Commission in the relevant documents including the complaints process. To ensure that staff sign for medication when it is administered. To ensure that the work required in areas referred to in the report was followed up. To employ a permanent housekeeper, this will enable the staff to spend more time supporting people using the service. To ensure that the fire system is tested and recorded weekly and in sequence. Key inspection report Care homes for adults (18-65 years) Name: Address: High Trees Care Home 4 Persehouse Street Walsall West Midlands WS1 2AS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Wendy Grainger     Date: 2 6 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: High Trees Care Home 4 Persehouse Street Walsall West Midlands WS1 2AS 01922615761 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Chatha Care Homes Limited care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 12 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: Learning disability (LD) 12 Date of last inspection Brief description of the care home Hightrees is a privately owned care home that provides accommodation to twelve people who have a learning disability. The home is made up of two converted Victorian houses. It is domestic in nature. The home is situated close to Walsall town centre with facilities such as shops, public transport, places of worship and pubs within the near vicinity. There is an enclosed garden to the rear of the property with on and off road parking. The fees for this home were not displayed in the Statement of Purpose or service users Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 12 Brief description of the care home guide. The reader may wish to contact the service for the current fees. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out on the 26th October 2009 by one inspector who used the National Minimum Standards for Care Homes for Younger Adults, aged 18 to 65 years as a basis for the inspection and outcomes for people who use the service. The manager and the staff provided written information regarding staffing, staff training, menus, risk assessments and care plans. Prior to the inspection we looked at the Annual Quality Assurance Assessment (AQAA), this is a self assessment tool, and had been completed and returned to us prior to the key inspection. Completion of the AQAA is a legal requirement and it enables the service to undertake a self assessment, which focuses on how well out comes are being met for people Care Homes for Adults (18-65 years) Page 6 of 29 using the service. It also gives us some numerical information. The AQAA was detailed although somewhat oversubscribed, information provided had to be filtered to obtain the information required for the core standards. We observed the breakfast routine for the people using the service and spoke to them about their routine for the day. We observed the morning routine for medication administered to the people during breakfast. We looked around the premises to have an understanding of the facilities provided to the people living at the service. We were provided with the menus and observed the choice offered at breakfast. We spoke to people using the service to ascertain their opinions about the service. Prior to the key inspection we had sent surveys to the service, surveys provide us with feedback of peoples opinions, staff awareness and training. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: To confirm in writing the placement, following the assessment to meet the needs of the person. Care Homes for Adults (18-65 years) Page 8 of 29 To include within the required documents the current fees for the service including any top up arrangements. To consider an alternative format for the Statement of Purpose and service users guide, this would enable people using the services to understand what the service offers. To update the details of the Care Quality Commission in the relevant documents including the complaints process. To ensure that staff sign for medication when it is administered. To ensure that the work required in areas referred to in the report was followed up. To employ a permanent housekeeper, this will enable the staff to spend more time supporting people using the service. To ensure that the fire system is tested and recorded weekly and in sequence. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience 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 chose to move into the service receive do not have the complete information they require to make and informed choice. Assessments are completed to ensure the service can meet individuals health and personal needs. Evidence: The AQAA we received told us that the Statement of Purpose and service users guide were displayed in the foyer of the service. These documents can be accessed by people using the service, visitors and other professionals. The service users guide was in a format with pictures and in an A-Z concept of answering questions. We saw the Statement of Purpose and the service users guide in the entrance to the service. The documents contained some pictures, not fully pictorial. The documents did not include the current fees for the service. People using the service were not provided with an alternative format, which would enable a new person to understand what the service can offer. We saw from the records that people who wish to move into Hightrees have an Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: assessment of their needs. This information was not reflected in the AQAA. We evidenced the information from the files for two people. The first care plan was the last person admitted to the service. From the records it was obvious that the person had been involved in the planning of care and support required. I need to be offered activities I enjoy, I need an escort to purchase items. We spoke to the people during the inspection who indicated or verbally told us that they were happy and well looked after. We discussed with the manager the need to confirm in writing that following an assessment of an individual, that the person is asssured that the service can meet and support their health, personal and pysical needs. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are involved in making decisions about their lives, and take an active role with the planning the support they need to further enhance their lifestyle. Evidence: The AQAA told us that people were fully involved in their care plan, this was confirmed from the records seen. The care plans were person centred and reviewed on a regular basis with the person. The care plans seen contained risk assessments, medical needs, and agreement to self administer medication. We were told by one person about her holidays abroad, this confirmed the information in the persons plan. We saw that all the people had a plan of care for the support required to meet their needs, including any medical needs, risk assessments and social interests and reviews. We saw the evidence of people being involved in their care plan the information also Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: included the monthly key worker reviews with individuals. This was confirmed from the surveys we sent to the service prior to the inspection. Surveys provide us with information about the service and the outcomes for people. One person told us, I like having my regular keyworking session, with my key worker, I enjoy having our meetings. One person told us about her holidays abroad, her daily routines using public transport to go to her place of work. We saw that the staff interaction was positive and met the peoples needs during breakfast, and their preparation to go into the community. We spoke to people who took us to see their bedrooms, they told us about families and the support the staff provide for them. One care plan clearly identified that the person chose not to meet with certain people this had been agreed by the person and the staff had been made aware. People have time in the community to enjoy a lifestyle that meets and suits their requirements. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by the staff to experience and enjoy a full social lifestyle. Evidence: The AQAA told us that documents are created to ensure that all the spiritual, and social needs of individuals are being recognised and respected. Where possible individuals sign the agreed discussion. Each person using the service had access to an advocate. People using the service and spoken with confirmed they are offered choice, this was evidenced during the breakfast being served. The one survey returned to us told us that I am provided with a choice of meals each day. The service has a four week menu in a pictorial format. People demonstrated their skills after breakfast by washing up, they told us they get the dishes ready for the dishwasher. We were told about the Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: recently purchased compost bin for the service ,but initially for one person who has an interest in gardening. We observed items in the fridge that were out of date, uncovered and not dated. This was part of the feedback to the manager. The staff need to monitor the fridge on a daily basis especially as the people are independent in preparing their lunches and snacks. When speaking to the people they told us about their work places and what they did. They told us about the way they manage the public transport. It was evidenced from the discussions and records seen that the people experience a full lifestyle and education they were also encouraged to take calculated risks. It was obvious during the inspection that the people had an open relationship with the staff and management. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service are protected by staff and management who meet their health and personal care needs.. Evidence: The AQAA told us that care plans for personal care and support required are person centered. The present people using the service require limited personal care support, some assistance is needed when bathing. Each of the people seen today were well presented and dressed appropriately for the weather and going into the community. We were told by the people that they did not have rules when they had to get up or go to bed, We can get up when we want, I like going out to the cinema or for a meal. We observed the medication process for the morning medication. One person was handed her medication to self medicate independently. This confirmed the plan of care and information from the staff. It is advised that staff sign on the administration of medication and not after. The service needs to collate written protocols for any prescribed medication to be administered when required (PRN). The service was advised to date creams when they were opened and to add to the records where they Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: were to be applied. This practice will further protect the people from any misuse of out dated medication. Medication is stored in a locked cupboard within the dining room and accessed by the staff only. We spoke to staff who confirmed the training for the safe handling of medication one person was waiting for her certificate. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service and able to make a complaint are protected by the current procedures in place. Evidence: The AQAA told us that the service had an effective policy and procedure in place for complaints. As part of the recruitment procedure prospective staff are asked their concept and response to any suspected abuse. People using the service on the day and in the returned survey that told us they knew who to speak to if they were unhappy. We evidenced the complaints procedure displayed in documents, and front entrance. The detail needs to be reviewed to reflect the correct contact details for us. The AQAA told us that the service had received one complaint, which had been investigated and found unsubstantiated. No referrals had been made to the safe guarding team or us since the last inspection. The manager told us she is planning to create a pictorial complaint format. This will enable the people to understand the process more fully. The service does not handle personal finances for the people using the service. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The design of the service and layout of the environment enable people using the service to live in a warm comfortable environment. Evidence: The AQAA told us that the service provides accommodation that met the required sizes, providing a comfortable, safe and personal environment. The service was suitable for wheelchair access at the rear from the car park. Since the last inspection the service had created three en-suites bedrooms. The newly created walk in shower room on the ground floor had been fitted with modern equipment. There were areas that had not been monitored in the daily cleaning schedules. The service would benefit from having a dedicated housekeeper this was part of the feed back to the provider. From the surveys returned by the staff one comment told us that it would benefit the service,if they had permananet staff to carry out cleaning and not to rely on agency people. There were areas in the kitchen which were damaged, doors off a cupboard and work surfaces and other areas in the service need a deep cleanseing. We saw the report recently sent to the provider by the environmental health officer who left requirements and recommedtions for the kitchen. We were told Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: by the provider that work to the kitchen was to comence the second week in November 2009. Communal areas were comfortable and well furnished, large windows and touches of homeliness. We spoke to a number of people who told us that they liked living at Hightrees. I cannot have a toilet in my room because its not big enough but I like my room, I chose the colour for my room. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The consistent well trained staff team support the people using the service while maintaining their safety. People may be put at risk with the current night staffing levels. Evidence: The AQAA told us that the service has been awarded the Investors in People for the second year. The staff turn over for the service is low. Staff are encouraged to support individuals on a daily basis, any new staff are supported to build up relationships with the people using the service. We evidenced positive interactions between the staff and people. We were told that the service endeavors to recruit staff with experience and if possible a National Vocational Qualification (NVQ). We identified from the training records that mandatory training had been undertaken, and on going. Records and staff confirmed that training for the Mental Capacity Act and Deprivation of Liberties had been undertaken over a period of time. We saw staff in sufficient numbers to meet the needs of the people during the morning and afternoon shift. We expressed concerns regarding the night staffing levels of one. Within the service there are a minimum of three people with recognised medical needs, each live in different parts of the service, which are not accessible Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: from the first floor across the two houses. This practice needs to be reviewed as the people using the services could be at risk. This was part of the feedback to the provider and manager. The AQAA information did not refer to the recruitment process. We identified from the records, staff files and surveys that the required checks prior to employment are carried out. This includes a Criminal Records Bureau (CRB) Protection of Vulnerable Adults (POVA) references and training records. People using the service were encouraged to be part of the interview panel for new staff they are asked to prepare a question they would like to know. This was confirmed by one of the people spoke with who asked about personality. We spoke to people at the service they told us that they like my home, the staff look after me. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is operated to the best interest of the people who use it. People using the service are safeguarded and supported by competent management systems. Evidence: The AQAA we received told us that the manager had the relevant management and nursing qualifications to benefit the service and people using the service. As part of her roll the manager undertakes the mandatory training she arranges for the staff, further enhancing her knowledge. She has been in the caring professions for over 30 years. We identified that her role and responsibility included the services audits, policies and procedures, supporting the staff with training, annual development plans and ensures the people using the service were supported and every opportunity was made available to them for their development. We evidenced from the records and by confirmation from the staff on duty, training was on going. This included the Mental Capacity Act and Deprivation of Liberties. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: The completed AQAA returned to us was detailed although the information had to be filtered to extract the core information. The manager continues to move the service forward with the people experiencing the community, being involved in recruitment, seeking feed back on a regular basis from meetings and surveys seen during the visit. Staff and management spoken with told us they felt supported by the manager who operated an open door policy for staff. The servicing of the equipment was satisfactory this was confirmed from details in the AQAA and records seen. We saw safe working practices in place implemented by the management. We identified that the manager need to review the system for testing and recording the fire tests. Weekly tests of the system were no always constant, the test points should be completed in sequence to ensure they are operating. It is advised that staff signed personally the fire records following any drill of training. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 32 18 To review and ensure that staff are employed in sufficient numbers to meet the needs of the people using the service. To ensure the safety of the people using the service night staffing levels need to reflect the medical conditions and care required. 10/12/2009 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 2 To ensure that the current fees for the service including any top ups and items not covered are part of the Statement of Purpose and service users guide enabling people to have the information. To confirm in writing to the person and or their representative following the assessment the placement is suitable to meet the individuals needs. To ensure that food is stored appropriately in the fridge. 2 2 3 17 Care Homes for Adults (18-65 years) Page 27 of 29 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 4 5 20 20 To provide appropriate storage for any prescribed controlled medication To review with the staff the process of recording medication when it was taken at the time appropriate to the individuals. To ensure that the areas refered to are renderd and areas deep cleaned. To ensure that the fire system is tested weekly and in sequence. 6 7 30 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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. 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