Care Home: Leatham

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What the care home does well Detailed information is gathered and shared to ensure that potential service users can be sure this home will be able to meet their needs. The manager and staff are fully committed to supporting the people who live here to lead purposeful and fulfilling lives. They engage with service users very well and understand their individualised communication styles. The service users have complex needs and the work is very intensive and challenging but the staff team are enthusiastic, skilled and work well as a team. They work hard to help service users access fulfilling social and recreational activities that interest and suit them. Staff encourage and support service users to make choices in their daily lives. The manager ensures that service users have access to independent advocates and other supporters to help them with changes in their lives and making important decisions. People`s health and wellbeing is monitored closely and the staff team liaise withother specialists and professionals to obtain the best outcomes for them. Staff have good training in how to understand and respond to challenging behaviours, which helps to protect service users. The home is clean and well maintained and provides spacious, homely accommodation. Service users are able to spend time where they wish. What has improved since the last inspection? This was the first inspection of the home since it became registered with the Commission. What the care home could do better: Ensure that each person`s care record contains a copy of their legally enforceable contract about their stay in the home. Service users should be helped to access routine eye check ups, which helps in the monitoring of their general health. Staff should sign the medication administration record immediately medication is administered, so that it is always up to date. It is also recommended the medication key be stored more safely, that checks be carried out to ensure that the medication is stored at the correct temperature, and short life medications are marked with the date they are opened. The manager needs to ensure that all staff have had training in safeguarding vulnerable adults and that they understand the whistleblowing policy and procedure. This helps to protect service users. An alarm on the exit door is very loud and intrusive. A quieter system would improve the environment for service users and staff.Staff are well trained but documentary evidence of their training needs to be kept on their staff records. Key inspection report Care homes for adults (18-65 years) Name: Address: Leatham 17 Leatham Sunderland Tyne And Wear SR2 0EW     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: Janine Smith     Date: 2 7 0 4 2 0 1 0 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 30 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Leatham 17 Leatham Sunderland Tyne And Wear SR2 0EW Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Peter Richardson Type of registration: Number of places registered: care home 6 NTW NHS Trust 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 : 6. 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 onadmission to the home are within the following category : Learning disability, Code LD, maximum number of places 6. Date of last inspection Brief description of the care home The home has been in existence for some years but was previously run as part of a hospital treatment service. The purpose of the home has now changed to one providing personal care and support for up to six people with a learning disability, enabling them to live normal lives in the community. Nursing care is not provided. The home provides single bedrooms for service users. There are sufficient toilets and bathing facilities. Ground floor accommodation is provided throughout. There are two lounges and a separate dining room. The home is surrounded on three sides by very Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home large gardens and has ample car parking at the front of the building. Information about the service is readily available and is provided in different formats to help service users understand it. Care Homes for Adults (18-65 years) Page 5 of 30 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: Most of the service users have lived in this home for some time but the purpose of the home has changed. Previously it was run as a treatment unit as part of a hospital, but for the past year has been run as a care home and as such became registered with the Care Quality Commission. This is a report of the first inspection since it became registered. Before this visit we looked at information we have received about the home since it was registered; how the service dealt with any complaints and concerns; any changes to how the home is run; the providers view of how well they care for people; the views of people who use the service and the staff. An unannounced visit was made on 27th April 2010. During the visit we observed practice in the home, spent time with service users and talked with staff and the manager. We looked at information about the people who use the service and how well Care Homes for Adults (18-65 years) Page 6 of 30 their needs are met. We looked at other records which must be kept and checked that the staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable. We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Ensure that each persons care record contains a copy of their legally enforceable contract about their stay in the home. Service users should be helped to access routine eye check ups, which helps in the monitoring of their general health. Staff should sign the medication administration record immediately medication is administered, so that it is always up to date. It is also recommended the medication key be stored more safely, that checks be carried out to ensure that the medication is stored at the correct temperature, and short life medications are marked with the date they are opened. The manager needs to ensure that all staff have had training in safeguarding vulnerable adults and that they understand the whistleblowing policy and procedure. This helps to protect service users. An alarm on the exit door is very loud and intrusive. A quieter system would improve the environment for service users and staff. Care Homes for Adults (18-65 years) Page 8 of 30 Staff are well trained but documentary evidence of their training needs to be kept on their staff records. 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 30 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 30 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. People who may use the service and their representatives have the information they need to help them decide if this home will meet their needs. Evidence: Most of the service users have lived here some time but the purpose of the home has changed. Previously it was run as a treatment unit as part of a hospital, but for the past year has been run as a care home and as such became registered with the Care Quality Commission. Copies of the organisations contract were in place on care records but not signed by any parties to the contract. The home has an appropriate system in place to ensure that any potential new service users are given the information they need to help them decide if the home can meet their needs. One potential service user has visited the home several times to see what it is like. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The manager had arranged for an occupational therapist to visit the home to assess what facilities it would need to have in place before a place is offered to the service user. Copies of the organisations contract were in place on care records but not signed by any parties to the contract. Care Homes for Adults (18-65 years) Page 12 of 30 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. Service users are involved in decisions about their lives and play an active role in planning the care and support they need. Evidence: Two care records were looked at, including care plans and risk assessments. These were comprehensive and detailed the individual needs of each service user and how these are met. Care records and other important documents were stored safely. The care records contained guidance on confidentiality and the importance of handling information appropriately. Time was spent observing daily life in the home. Each service user has complex communication needs and observations indicated that staff understood peoples preferred communication methods and listened carefully to what they had to say. The staff confirmed they use photographs and other methods to help service users make Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: choices in their daily lives. Service users were seen to follow their own preferred daily routines and choose when they wanted to do things and where to spend their time. Independent advocates are obtained for people to help support them when they have important decisions to make and to ensure that their views are represented. Care Homes for Adults (18-65 years) Page 14 of 30 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. Service users are able to make choices about their life style. The staff work hard to help service users access social and recreational facilities that interest and suit them. Evidence: The manager and staff are exploring different activities for individual service users in the home to help widen their participation in the community and provide them with stimulating past-times. Records, discussion with staff and observations made showed that service users are supported to enjoy a good range of activities. For example, one visits a hydrapool and is trying trampolining. Another was visiting a drop in musical band. They have had meals out, visits to the pub, trips to the theatre. A number of other activities are also planned and the manager is keen to develop this part of peoples lives further. Holidays are also being planned. There was evidence in records, photograph and comments from staff and service Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: users to show they are supported to keep in touch with their families. Service users follow their own preferred routines. For example, one service user got up late and got ready at her own time and pace. She had a key for her bedroom door. Service users moved around the home as they wished and spent time with whom they wished. Two service users have become good friends. A four week menu plan is in place which looked varied and healthy. Advice has been sought from a dietician about the menu plan and she also monitors service users weight. Staff described how they use pictures to help people make choices. Service users go out for lunch regularly. A meal is home cooked each night. A seating plan has been drawn up for mealtimes using three separate dining tables. This enables service users to receive support and for staff to chat with them. Some had sandwiches, some had soup, followed by yoghurt and fresh fruit. Staff were aware of peoples likes and dislikes. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs, which means they are shown respect and dignity. Evidence: Staff spoken to were well informed about the needs of people they care for and how they communicate if they cannot verbally say what they want. Personal support is provided in private and peoples wishes regarding the gender of the person who provides personal care are respected. Specialist advice is sought if service users or potential service users may need specialist equipment or facilities. Care records showed that GPs were contacted if service users were unwell and they saw consultants and other specialists when necesssary. Where service users are not able to give consent to medical procedures, meetings are held with relatives and other professionals to decide what is in the best interests of the individual concerned. Records showed routine check ups by dentists and chiropodists but not by opticians. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Medication was discussed with the manager who described appropriate systems for ordering, administration and disposal of medication. A sample of records indicated these were kept properly except that lunchtime medications had not been signed for on the day of inspection. Two of the staff confirmed that they had received training in medication. Staff are trained to administer medication. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, which means their views are listened to. They are protected from abuse and have their rights protected. Evidence: A thorough complaints management file is in place, which contains guidance to staff about the complaints procedure and how to respond to complaints as well as guidance on investigating complaints. It also contained a record of compliments received. One had been received recently from a health care service. No complaints had been received. Care files looked at contained pictorial copies of the Trusts How to Complain. Most service users cannot communicate verbally easily so staff observe other signs of their wellbeing. Staff have been trained about how to respond to behaviours which they may find challenging and have had training in control and restraint. This helps them understand that service users may present behaviours as a way of communicating. One member of staff confirmed they had had training in safeguarding vulnerable adults and understood the whistleblowing policy. Another person was unsure about the concept of whistleblowing and has not had training in safeguarding vulnerable adults Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: yet. Two members of staff confirmed that they had had training about the Mental Capacity Act and Deprivation of Liberty safeguards. Appropriate action has been taken under the Mental Capacity Act to safeguard individual service users. Staff could describe how service users made their views known. The staff team help service users manage their money and bank accounts. There is a thorough system in place so that all transactions are recorded and checked. Care Homes for Adults (18-65 years) Page 20 of 30 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 physical design and layout of the home provides service users with a safe, comfortable well maintained home. Evidence: The home is spacious, clean and well maintained. Each service user has their own bedroom which were personalised and homely. There is a large lounge and a smaller lounge used mainly if people want a quiet time. There is a separate dining room next to the kitchen. It has large gardens on three sides and car parking area at front of home. Toilet and bathing facilities meet the needs of the people living here. The manager is exploring whether the facilities can be changed to enable the home to provide care for someone with mobility difficulties in future. Staff check the temperature of hot water supplied to baths to ensure it is safe and keep a log of this. Radiators have safety covers fitted to protect service users from burns. The laundry was well equipped and has handwashing facilities, handwash and paper towels. Potentially hazardous substances were locked away securely. Staff have Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: access to gloves and aprons. The Kitchen is kept locked most of the time to protect one service user who is liable to race in and lean on the hot hob. The front door has a door alarm fitted, which emits a very loud, startling alarm every time it is opened. As the door needs to be opened frequently, the alarm is very intrusive. Care Homes for Adults (18-65 years) Page 22 of 30 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. Staff in the home are trained, skilled and in sufficient numbers to support service users, which means service users can receive care of a good quality. Evidence: The rota and discussion with the manager and staff showed that the home is staffed by four support staff between 8.00 am to 8.30 pm and by two waking staff between 8.00 pm to 8.30 am. Staff commented that there were sufficient staff to meet the needs of service users. There are out of hours arrangements in place, should staff on duty need advice or support during the evening or night. Two staff have left so the home is currently drawing on its own pool of relief staff for some shifts. There is a balance of male and female staff to meet the wishes of service users about who should help them with their personal care. Two staff records and a training plan matrix were looked at which showed each member of staffs training and what was current, out of date and due to expire. These documents showed that training for staff included equality and diversity, control and restraint, breakaway techniques, epilepsy, sudden death in epilepsy. One member of staff had completed induction training and National Vocational Qualificiations (NVQ) at Levels 2 and 3. The other showed the member of staff had completed an NVQ2. The Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: member of staff concerned was also able to confirm they had had training in epilepsy awareness, sudden death in epilepsy, pandemic flu awareness, equality and diversity, control and restraint and was going to do training about deprivation of liberty. They had asked to do NVQ3. Another member of staff confirmed that they had worked there for over a year. They had had Learning Disability Qualification induction training and were always worked with another experienced member of staff until they felt confident about their role. They had subsequently had training about epilepsy, control and restraint, sudden death in epilepsy, equality and diversity. Both staff confirmed they have regular meetings (known as supervision) with their manager to discuss their work and any issues arising from this. There was a lack of training certification on the staff records. Recruitment and selection processes were inspected in a separate visit to the Trusts head office in 2009 when a recommendation was made that gaps in job applicants employment histories should be explored more thoroughly. Care Homes for Adults (18-65 years) Page 24 of 30 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 management and administration of the home is based on openness and respect and there are effective quality assurance systems in place. This helps ensure that the quality of care is being checked to make sure service users receive good care. Evidence: The registered manager is a qualified nurse and has a wealth of management experience. Annual surveys are carried out of service users and relatives as part of the quality assurance process. Regular meeetings are also held with service users to find out what they like. The minutes of the last service users meeting had been put on a disc so that they could be read out at the next meeting to enable service users to participate more. The minutes showed that one service user wanted to go dancing, on holiday and have journeys on the metro system. Reports were seen of regular unannounced visits carried out by a senior manager from the organisation. These are a regulatory requirement. The visits covered a number of Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: areas and included meeting service users and staff. Incident records are reviewed and any issues from the previous month are followed up. The manager is given a report which identifies what he needs to address. Policies and procedures can be accessed by staff using the homes computer which is linked to the homes intranet. A copy of the homes whistleblowing policy and procedures could be quickly found. Care plans and other records were stored securely in locked wall cupboard. Maintenance records were seen for fire alarm, emergency lights, gas system. Following the inspection, confirmation was received that the electrical wiring system has been checked by a competent person. The fire log book showed monthly checks on emergency lights and fire instruction to staff. The fire risk assessment was in place. The records for two staff were looked at. One had had training in medication, fire safety, first aid. The other record said they had had mandatory training but it did not define what this included. Another sheet showed this person had had fire safety, health and safety, moving and handling. This member of staff confirmed they had had training in moving and handling, first aid, food hygiene, fire safety and health and safety as well as medication. Another member of staff confirmed they had had had mandatory training but couldnt remember everything it covered. They confirmed training in fire safety and medication. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 23 13 All staff must have had training in safeguarding vulnerable adults from abuse and must also understand the whistleblowing policy and procedures. This helps to protect service users from abuse. 31/08/2010 2 35 19 Staff records must contain documentary evidence of their training, such as certificates. This helps to demonstrate what training staff have been given. 31/07/2010 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 5 Ensure that the appropriate signed contract is in place on service users records. Care Homes for Adults (18-65 years) Page 28 of 30 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 2 19 Ensure that service users get support to access opticians for routine eye tests at the frequency recommended by the NHS. This will help identify any health conditions that need treatment. Staff should sign the medication administration record immediately after the service user has taken their medication. This ensures the medication administration records are always up to date. The key to the medication storage should be kept safe by the responsible person or alternatively stored safely where it can not be openly accessed by other people. The containers of short life medications, such as eye drops, such be marked with the date they were opened. This helps to ensure that they are not used beyond the recommended date for safety. The temperature of the medication storage area should be monitored daily to ensure that medications are stored at the correct temperature. 3 20 4 29 Consider installing a less intrusive alarm system on the exit doors, so that staff can be quietly alerted if anyone enters or leaves the premises. Ensure gaps in employment shown on application forms are fully explored and this is clearly shown within the record of interview. 5 34 Care Homes for Adults (18-65 years) Page 29 of 30 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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