Care Home: Jubilee House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Jubilee House 2 Kent Road Moorside Consett Co. Durham DH8 8HN two star good service The quality rating for this care home is: 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: Kathy Bell Date: 1 5 0 1 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 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Jubilee House 2 Kent Road Moorside Consett Co. Durham DH8 8HN 01207580311 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Positive Approach Services Limited Name of registered manager (if applicable) Lesley Margaret Weatherhead Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: Date of last inspection 1 9 1 2 2 0 0 6 A bit about the care home Jubilee House is a private sector care home for up to eight adults with learning disabilities. It does not provide nursing care. It is on the outskirts of the town of Consett. Jubilee House has bedrooms on the ground and first floor. It does not have a lift but is not intended for people who have physical disabilities as well. Two of the people who use this service share a bedroom. One of the single ground floor bedrooms has an en suite shower and toilet. Since the new company took over the home two years ago, much work has been done to make the building more attractive and comfortable. 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 How we did our inspection: This is what the inspector did when they were at the care home This inspection took place during one day in January 2009. It was a planned inspection but we did not tell the home when we were going to visit. The last inspection of the home took place in December 2006. During the visit we looked around the building, although not in every room, talked to the manager and 4 people who live in the home and briefly to staff. We also received surveys completed (usually with help by staff) by 8 people who live in the home and from the mother of one person, and a care manager. The manager sent us a report (the AQAA). This report gives their view of what the home is doing well and what it could do better. We used this information when we did the inspection. In the last report we may have told the home to improve what they do. We call this making Requirements or Recommendations. If the home hasnt done what we told them to, but this doesnt affect peoples safety, we may not tell them to do it again. But, in future, if we have to tell a home a second time, we will probably take action to make them do what we say. The last inspection on the service was completed on 19 December 2006. What the care home does well The home provides a small-scale long-term home, with staff who are committed to the home and know residents very well. In the last year, people who live in the home have been encouraged to consider their own goals for the future and are being helped to lead more independent lives. Most people have varied, interesting lives with opportunities to learn new skills. The company which owns the home has been providing extra training staff so they have the skills to do their jobs in the way the company expects, particularly in the area of recording. What has got better from the last inspection The home has put in place personcentred care plans, which described the care people want and need. There has been a major programme of redecoration and improvement of the building. Staff have had more training. At the time of the last inspection the home did not have a manager. Since then a manager has been employed and is registered as manager with CSCI. What the care home could do better The care plans must include all the information staff need to look after people. They must be kept up-todate. Staff must check the information provided by the care manager, when someone is admitted, to see if it mentions any possible risks to the person. If it does, the home must act on this advice. Staff must do as much as they can to stop the person coming to harm. If someone cant easily tell staff what they like and dont like in the way they are cared for, staff should write guidelines explaining what the person likes to happen through the course of the day. In this way staff can share their knowledge and experience of what person wants and new staff are helped to provide the care in the right way. Again, if someone cant easily say what food they like, staff should write a list of the food they have found the person likes and what they dont like, to help them provide meals they will enjoy. The manager should discuss with people who live in the home what they would like to do at weekends and consider any necessary change to staffing levels to make this possible. Staff should record all minor complaints together so the people managing the home can see that they are responding properly, and see if any lessons need to be learned from them. Staff should receive training in the specific conditions people living in the home have. The company which owns the home should make their plans to improve the quality of the home better by having more specific goals in it. The owners of the home must assess if there are any risks to residents because of metal radiator covers and unrestricted first-floor windows. They must take into account current guidance from Health and Safety Executive and consult with their local Environmental Health Officer. The manager should achieve NVQ 4 in care. 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 Kathy Bell St. Nicholas Building St. Nicholas Street Newcastle upon Tyne NE1 1NB 019 1233 3300 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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 home makes sure it will be able to meet peoples needs by obtaining information about them before they are admitted. Evidence: We looked at the records of the last person to be admitted to the home. These showed that the home had obtained an assessment by her care manager. They had also received information about her needs, choices and routines from the people who had previously cared for her. They sent a questionnaire to her parents so they could obtain detailed information about her needs and abilities from people who knew her very well. 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 . Each person has a care plan which explains the help they need. These did not always include all the information they should but staff know the people who live in the home very well. The home helps people be independent, while keeping them safe as far as possible. But in one case, they had not taken action to look at the risks of someone having a bath by themself. People can make choices in their daily lives and are encouraged to do this. Evidence: Each person who lives in the home has a care plan which explains about them and about the care they need. Whenever possible, each person had helped their key worker write down information about them and their life so far. The care plans explained the help they needed staff to give them for their personal care. As far as possible, people were looking after themselves, with staff just prompting them or helping them with things they found difficult. There were guidelines for staff, telling them how to respond if someone became angry or upset. Generally, staff ask someone to go to their room until they feel more calm, and then talk about what has happened to upset them. But the care plans had not always been kept up-to-date and they did not all include all the information needed. For example, they had not written down information about dietary needs. A care plan still said someone never liked a bath although the manager said he does really enjoy a bath now. But this is a small home with few changes in the staff or the people who live there. So staff usually know what help someone needs, even if it isnt in the care plan. But they need to work harder at making sure everything is in the care plan,to make sure everyone provides the care in the way people want. This is particularly important for people who cant express their Evidence: views easily. Care plans did include the short and long-term goals each person had decided on. Each month, the key worker, a member of staff who has particular responsibility for a resident, does a summary of what has happened in their lives. They use these summaries to help them do the annual review of the care. Care plans also include risk assessments, where staff look at any activities people want to do, which could put them at risk of harm, and write down the safeguards which must be in place. For example, they explain when someone wants to travel on the bus independently, how they will carry a mobile phone and how staff will check they know the route etc. These risk assessments all support people in leading a more independent life, while making it less likely anything will go wrong. But in one case, the assessment by the care manager should have made the home aware that they needed to look particularly at the risks to someone, of having a bath independently. The risks might be small but they should have discussed with the person and the care manager how best to respect their independence and privacy but keep them as safe as possible. The manager took prompt action once she realised this. The daily records show that people are making choices in their daily lives. One resident explained that they are encouraged to say what they want and they have monthly house meetings. Another said that in these meetings, they discuss things like where they would like to go on holiday and what shows they would like to go and see. People said that they could choose when they wanted to go to bed, whether they wanted to sit in their rooms or be in the lounge with the others. One person said, Now I am learning to make my own decisions. In the surveys, when we asked if people make decisions about what they do each day,3 said always and three said sometimes. But when we asked if people could do what they wanted during the day,in the evenings and at weekends, almost everyone said they could. People who said they couldnt do what they wanted at weekends, said this was because of a lack of money. Records showed that people look after their own money as much as they can. 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 live in the home take part in a wide range of activities and are helped to be independent. Staff respect their rights to personal relationships and help them maintain family contact. People who live in the home are involved in the daily tasks of looking after it, preparing meals etc. Staff provide the meals which people choose but aim for a healthy diet. Evidence: People take part in a wide range of daily activities. The manager explained that some people have recently changed what they do, to better match their interests and needs. One person goes to a traditional centre for people with learning disabilities, others go to a local day-care provider and their days include a range of activities. People also go to theatre groups, literacy classes and a local drop-in centre. One person works in the kitchen which provides meals for this centre. In surveys most people who live in the home said they could do what they wanted but two who said they couldnt do what they wanted at weekends said this was because of lack of money. There are normally just two staff on duty at weekends which will limit how much they can go out with people. But staff should discuss if there any other activities they would like to do at weekends. Within the home, staff have a supply of games, puzzles etc but were not always recording when residents were doing activities in the home. Some residents like to help prepare meals. People said that they are all expected to take responsibility for the daily life of the home, according to their abilities. Some clear tables, another mentioned staff helped her tidy her room on a Evidence: weekend. Most people who live in the home use public transport to go out and use local shops etc. Records showed they go to shows or films at the local theatre/cinema. This year some went on holiday to Turkey and some to a caravan park. A trip to London to see a show is planned. The home has worked with care managers to support one person in maintaining contact with her family. Staff have respected one persons rights to personal relationships. Staff ask people what they would like to eat, and plan each weeks menu at a time. But they do encourage healthy eating and the menus show a varied and nutritious diet. The manager explained how they know some people wont like the meal chosen by the others so they are given something different. One of the people who use the service told us that if he did not like the meal, staff would give him something else. Staff knew about one persons particular dietary needs and take these into account when planning the meals. 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 receive the personal and health care support they need. Their medication is looked after safely. Evidence: Each person has a care plan which explains the help they need. These say clearly what people can do for themselves so that staff only help them with the things they really do need help with. A resident said that she was treated like an adult now and the mother of someone who does need help with most personal care said that he was always treated with respect for his privacy and dignity. The home seems to work effectively with care managers and asks for specialist support when necessary. A care manager said that the home is good at promoting ongoing self-development and independence for service users. Records showed that staff are alert to any medical problems, seek advice and help people go to medical appointments.The mother of someone who lives in the home and a care manager both said that the home always asked for advice and acted upon it to manage and improve individuals healthcare needs. Good level of ongoing communication to check out things are progressing etc. Both said that healthcare needs were always met- staff support service user to maintain a healthy lifestyle and attend any health appointments as necessary. Records showed the home refers to specialist sources of advice when necessary. A member of staff explained how staff have been made aware what the results of the blood tests they do for one resident with diabetes mean, and when the results are too high and they should seek medical advice. All the staff have received full training in how to look after medication safely. There is an established system for ordering, storing, giving out and recording medication. As an Evidence: extra safeguard, two staff, wherever possible, give out medication. The manager is setting up a page in the care plan where staff will record if someone has had a bad reaction to a drug, so they have that information available when they go with someone to the doctor, in case the doctor is considering giving the same drug. 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 the home can make complaints and staff respond properly to them. But staff should record complaints in a separate record. People are protected from harm as far as possible. Evidence: The home has a satisfactory procedure for responding to complaints.This is also available in a picture format for people who might find this easier to understand. When we asked this in the surveys, everyone who lived in the home said they knew who to speak to if they were not happy and how to make a complaint. There have not been any recorded complaints but the manager said when one person living in the home complained about another, they recorded this in the daily notes. The manager said that they always recorded whether the problem was settled to everyones satisfaction. This suggests that they are treating these complaints seriously as complaints, but it would be better to record them in a complaints record. This would mean that the people who own the home and inspectors would be able to see clearly that staff do listen and respond when people are unhappy about something. The mother of someone living in the home confirmed in the survey that staff had responded appropriately if she raised any concerns. A care manager said that, issues quickly resolved amicably. Records showed that the home had supported someone to make complaint about an advocate. This is good as it shows staff support people to speak up for themselves. All the staff have had training in safeguarding adults, knowing how to recognise abuse and what they should do if they think it has happened. There is a satisfactory system for looking after residents money. Receipts have to be provided and staff have to fully account for any claims for mileage money when they have taken residents anywhere. 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 home provides a comfortable place to live which meets peoples needs. Evidence: The home is a large detached house on a housing estate. Downstairs there is a living room, dining room and conservatory, as well as a kitchen and laundry room. All but one of the bedrooms are single and one downstairs bedroom has an ensuite toilet and shower. There is also a bathroom with toilet, a shower with toilet and a separate toilet in the building. The current owners have carried out a major refurbishment of the home, redecorating throughout and providing new carpets. More improvements are planned. 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 staff in this home are experienced and qualified and have had most of the training they need. There are enough staff to run the home safely but the manager should look at when staff, including her, are on duty, to make the best use of the hours available. The home carries out checks on new staff to make sure, as much as they can, that only suitable people start work there. Evidence: The National Minimum Standards recommend that at least half of staff in each care home achieve the recommended qualification for care workers, the National Vocational Qualification in care at level 2. Jubilee House has done better than this-all the staff apart from the newest one already have this and she has nearly completed it. The senior carer has the NVQ in care at level 3. Staff seem to have the personal qualities needed for their job. People who live in the home described them as supportive, friendly, very nice, wonderful, and said they listen and understand. During the inspection we saw that staff take a generous view of their duties-even when they are not at work in the home they will do things like baking a birthday cake or turning up the hem on someones new trousers. There have been very few changes in the staff group which means that most staff have known most of the residents for years. The rota showed that there are always at least two people on duty through the waking day. Staff work extra time if people need to be taken to appointments. One member of staff sleeps in at night and then is on duty from 7 a.m. to 10 a.m. so they can help get people up and have breakfast. In a home this size, we would expect that the manager can spend some of her time with residents as well. Most people can go out independently and need little help with personal care so the staffing levels seem enough to run the home safely. But the manager should look at whether she should work at different times to make it easier to provide activities outside the home. Evidence: We looked at the records of the recruitment of the newest member of staff. These showed that the home had carried out the proper checks to make sure that, as far as possible, only suitable people start work in the home. They had obtained two references and a Criminal Records Bureau/Protection of Vulnerable Adults List check before she had started work. The home has a training programme and has made sure that all the staff have had essential training such as first aid, moving and handling, safeguarding adults and food safety. Training in understanding challenging behaviour, communication and infection control has also been provided. In the last year, they have had extra training to make them more confident in keeping records. They have all had training in person-centred planning and writing reports. The manager has recently been arranging training in dementia to help staff have the understanding they will need to continue to meet peoples needs. But only one member of staff has had any training in diabetes, although one resident has diabetes. 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 manager is experienced and is working towards the recommended qualifications for care home managers. The company which runs the home does check on the quality of care but could improve how it does this. Generally the home seems a safe place to live and work but the company must check if metal radiator covers and unrestricted first-floor windows pose any risk to residents. Evidence: The manager has about 15 years experience of working in care homes and has been working here since February 2007. She has achieved part of the recommended qualification for managers, the Registered Managers Award. But she should still study for the NVQ in care at level 4. The owners of the home have several systems to check on the quality of the care they provide. They carry out the monthly visits which are required by law. The reports of these show that they are done thoroughly. They find out the views of residents at monthly meetings. They were due to send out surveys to relatives and care managers, asking what they thought of the home. We looked at this survey and thought the home could improve on it, by asking more questions. The company which runs the home uses the surveys to form a plan to maintain and improve the quality of care. But this would be much more useful to them if it included more detail and set more specific goals to be achieved. But in the Annual Quality Assurance Assessment which she completed for us, the manager identified what she should do to improve the care in the home. Staff carry out regular checks to make sure the home is running safely. The manager Evidence: completes a health and safety checklist regularly. Staff check the fire system is working properly and that the hot water is at the right temperature. This year they have had the electrical installation of the building checked for safety and also portable electrical appliances. They do carry out fire drills but have not made sure that each member of staff takes part in them, at least every six months. But the company is providing formal refresher training in fire safety every six months. We noticed two things in the building which could cause a risk to residents. The radiators had been covered, but with metal covers which could still get very hot. The upstairs windows had not been fitted with restrictors to limit how far the window could be opened. These are fitted when there is any risk that someone could fall out. It may be that the current residents in this home are not at risk but the management of the home must carry out a full risk assessment for these two things, for each person, taking into account current good practice guidance. If action is needed, they must take it promptly. 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 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 1 6 15 Care plans must always be 20/02/2009 kept up-to-date and contain all the detailed and specific information staff need to look after people in the way they want. Care plans are essential for staff to know exactly how they are meant to care for people 2 9 13 Staff must use the care 20/02/2009 managers care plans to alert them to any risks, which mean they need to take action to protect people. They must do this to make sure they assess all known risks to people who live in the home, and take appropriate action. 3 42 13 The owners of the home 20/04/2009 must assess if there are any risks to residents because of metal radiator covers and unrestricted first-floor windows. They must take into account current guidance from Health and Safety Executive and consult with their local Environmental Health Officer. This is to ensure the safety of people who live in the home. 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 6 When someone cannot say what they want, staff should include in the care plan a list of the food they like and dislike. The manager should discuss with people who live in the home what they would like to do at weekends and consider any necessary change to staffing levels to make this possible. For a person who cannot say what he wants very easily, staff should create a written plan of the way he likes to live and have his care provided through by 24 hour period, to make it easier to do what he wants. Staff should record all minor complaints together so the people managing the home can see that they are responding properly, and see if any lessons need to be learned from them. Staff should receive training in the specific conditions people living in the home have. The manager should achieve NVQ 4 in care. The company which runs the home should include more specific goals in its improvement plan. 2 14 3 18 4 22 5 6 7 35 37 39 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. 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