Care Home: Lifeways

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What the care home does well Lifeways 95 Queens Drive provides an excellent respite service for young adults with learning disabilities. It provides an individual programme of care based on a full assessment of needs and a detailed care plan to meet those needs. The premises are pleasant and well maintained to provide a homely and comfortable environment. The home has a full range of policies and procedures to ensure that good practice is followed in all areas. The activities are varied and the home uses local facilities excellently to provide a varied and stimulating stay. All contact with people who use the service and their families resulted in very positive comments about the home and included "I would like to thank all the staff for my wonderful stays at Queens Drive". The home is excellently managed with a well trained and well motivated staff group resulting in a high level of practice. What has improved since the last inspection? Since the last inspection the registered manager has addressed the outstanding issues identified. There are now full care needs assessments in place to plan the work. The home has improved the garden area to ensure that it is safe and usable for people staying there. More training in risk assessments has been undertaken and applied in the home to further enhance safety. Vocational training is now being undertaken to further develop staff and male staff are available when required to meet individual needs of people using the service. What the care home could do better: This key unannounced inspection has identified very little that is required to improve practice. Care plans should be reviewed every six months to ensure they are up to date. A visit and report from an external source is required on a monthly basis to improve the monitoring of performance. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lifeways 95 Queens Drive Newton-le-Willows St Helens Merseyside WA12 0LP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: John Mullen     Date: 1 5 0 6 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Lifeways 95 Queens Drive Newton-le-Willows St Helens Merseyside WA12 0LP 01744632553 02088779543 lancashire@lifeways.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Lifeways Community Care Ltd care home 2 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 2 Service Users to include up to 2 in the category of Learning Disabilities. The service should employ a suitably qualified and experienced manager who is registered with the Commission for social Care Inspection. Date of last inspection Brief description of the care home 95 Queens Drive is a respite home for up to two adults with learning disabilities. It is managed by Lifeways Community Care Ltd and the registered manager is Mrs Amanda Jayne Critchley-Riley. The home was established to partly replace the respite service provided by St Helens Council and all referrals are through the Council. 95 Queens Drive is a domestic property with a lounge, a dining room, two single bedrooms for residents and one for staff. The home has one downstairs toilet and one upstairs toilet with shower and a separate utility room. It was registered on 15th September 2005. The home charges 11.00 per night although this may be reduced according to an assessment of service users means. Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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: The quality rating for this service is three stars. This means that people who use this service experience excellent quality outcomes. This was a key unannounced inspection of Lifeways 95 Queens Drive Care Home which included a visit to the service. All key standards were assessed in addition to a selection of other standards. This inspection encompassed information received since the last inspection including the Annual Service Review of 26th June 2008. In addition it included information provided by the home through its Annual Quality Assurance Assessment document (AQAA). The AQAA gives a picture of the overall performance of the agency as well as Care Homes for Adults (18-65 years) Page 6 of 27 factual information about the service. Interviews took place with the registered manager and the senior support worker. Three users of the service were case tracked; that is their care was examined in detail. Two people who were staying in the home were interviewed and comment cards were received from users of the service and family members. The premises were inspected and a large amount of documentation examined. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides care based on a full assessment of needs. Evidence: An interview with the registered manager confirmed the information in the AQAA that full care needs assessment material is present in all cases to direct staff. This was confirmed by the senior support worker who stated that the information received was very detailed and relevant to guide staff. She said they were well aware of the specific needs associated with each person staying in the home. An examination of files found detailed and relevant information in each to enable staff provide a level of care which is both appropriate and effective. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The practices of the home result in a safe and effective service that involves service users in their own care. Evidence: An interview with the registered manager confirmed that care plans are in place and they are being reviewed regularly so that they are updated. The home attempts to involve families and people who use the service in the reviews to ascertain their views. However, she did confirm that the care plans are not necessarily reviewed at six monthly intervals both because of the intermittent nature of the care and because of her understanding of the standards. An examination of a selection of care plans found them of an excellent standard which were very detailed and gave good guidance to staff in all aspects of daily living. The senior support worker interviewed felt the care plans gave good guidance to staff on the work to be undertaken in respect of individual people staying in the home. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: The AQAA showed a strong commitment to involving people staying in the home in decision making, so that they have an active part during their stays. This was confirmed by interviews with both the registered manager and the senior support worker who could give excellent examples of service users making decisions and being supported to widen their skills as a result to their involvement during their stays. Observations during the visit to the home showed that people staying there were asked about their wishes during their stay and this was confirmed by minutes of house meetings which confirmed active participation in the home. One comment card from a person who had stayed in the home included the statement the staff take my opinions very seriously. The last key inspection found some deficits in the risk assessment process but both the Annual Service Review and the AQAA confirmed that these had been addressed, resulting in a safer service. This was confirmed by the visit to the home. The registered manager stated that she had undertaken three hundred and fifty new risk assessments on people staying in the home to update and improve the process. She also confirmed that she had received recent training in the process as had the senior support worker to update their knowledge. The registered manager stated that risk assessments were being reviewed on a six monthly basis to confirm their relevance. An examination of the files of people who stay in the home found very detailed, specific and up to date risk assessments in place to show that risk is being managed effectively. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes an excellent lifestyle resulting in an individualised and rewarding stay. Evidence: An interview with the registered manager showed that there were a varied amount of activities on offer to occupy people staying there. It also revealed that the home supports them to attend educational establishments when this is appropriate. The visit to the home found very detailed and documented activities available. This included through a voluntary organisation, Heroes, which is providing certificated activities which, the registered manager said, was particularly appreciated by people staying there. An examination of their files found full details of activities with an assessment of their success to aid future planning. People staying in the home on the day of the visit were choosing their own activities and comment cards received were complimentary Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: about the home, one stating we do a range of varied activities. Both the registered manager and the senior support worker were complimentary about the neighbourhood. The former said they had brilliant neighbours which has made the integration of the home into the community much easier. An examination of documents on the day of the visit confirmed that the home uses a whole range of community facilities as required so that they are part of the community. The premises themselves easily blends into the surrounding area which helps integration. The AQAA stated that the home has a number of formal links with families and relatives, including coffee mornings and surveys to assist communication. An examination of the comments received from a survey of families showed that there are very positive links between them and the home. The effectiveness of communication was particularly commented upon by families to show the effectiveness of these links. The registered manager could show that she seeks the involvement of families in the work of the home, particularly by reviewing cases in the homes of people who use the service in many cases. Comment cards received from families assisting service users in their completion were very positive about the work of the home and the level of communication being maintained. Interviews with the registered manager and the senior support worker showed that the home is particularly committed to promoting the independence of people living there and developing their skills so that they can have a more involved stay. Observations on the day of the visit showed that pleasant and appropriate interaction was taking place resulting in a positive atmosphere. Both the registered manager and the senior support worker confirmed that people staying there have unrestricted access to the home to the extent that this is compatible with their wellbeing. All comments from them were very complimentary about their experiences in Queens Drive and included I was very pleased with everything and I am very pleased with the home, and very happy. The AQAA stated that the previous high standards found in the area of meals was continuing with appropriate practices. The registered manager confirmed that menus are planned in advance on the basis of known likes and dislikes so that acceptable meals are served. The visit to the home found menus available which showed that nourishing meals are served. It also found that in the files of people who stay in the home that likes and dislikes are listed so that these are known. Equally house meetings discuss food to meet individual tastes. Contacts with people who stay in the home confirmed a positive view of meals and mealtimes in Queens Drive and included the comment I am fed well. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the personal and healthcare needs of people who stay there in a systematic and detailed manner. Evidence: All contact with people who use the home and their families revealed a good opinion of the personal care being practiced in the home which they felt was of a good standard. An interview with the registered manager confirmed that the home cares for people in a practical but sensitive manner so that their needs are met appropriately. The home does not use a key worker role for staff due to the size of the staff group and the respite care being provided. However, interviews with staff and comment cards from them all showed a high commitment to a good level of personal care in the interests of people who stay in the home. The home still does not have any permanent male staff but can use bank staff when required so that specific needs of male users of the service can be met. As a respite facility the home does not access healthcare provision routinely but only as required. An interview with the registered manager confirmed that this is being Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: done appropriately so that needs are met. A review of evidence on this service, plus the Annual Service Review revealed no concern about the manner in which the healthcare needs of people who use the service are met. An examination of their files found that the healthcare needs were detailed and present in the care plans so that they are well known. A review of the evidence about this home showed there had been one incident referred to us of wrong administration of medicines which had been dealt with correctly and thoroughly to ensure that no harm ensued. An interview with the registered manager, confirmed by training documents seen, showed that all staff are routinely receiving training in this area to reinforce good practice. An examination of files of people who stay in the home found very detailed, and recent, information on each person so that staff are clear about the medicines and their purpose. It also showed that medicines administered were generally recorded in a correct manner with very slight exceptions. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service protects its users through appropriate policies and training of staff. Evidence: A review of evidence found that no complaint has been referred to us confirming a high level of satisfaction with the service. The registered manager reaffirmed the AQAAs statement that there had been no complaint about the service. A tour of the premises found that the complaints procedure, along with other relevant information, was affixed to the back to each bedroom door to show that this information is freely available. It was also contained in each service user file seen which also had evidence that this has been sent to each family to further show an open approach. The AQAA stated there had been no safeguarding issue surrounding this service which further confirmed its safety. This was reinforced by the visit to the home which revealed that the registered manager was fully aware of her responsibilities in this area to safeguard people using the service. An examination of training documents confirmed staff are trained in this subject at induction and subsequently to update their knowledge. An examination of the service file found no safeguarding issue that had been referred to us thus confirming the evidence already reported. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises provide an appropriate environment for the safe and homely care of people using the service. Evidence: The last inspection found the only concern in respect of the premises was the unsuitability of the garden area for people using the service. Since that time, this matter has been remedied resulting in a much improved facility which people using the service can use fully and safely. Otherwise, the home remains fit for purpose being homely and comfortable for people staying there. The bedrooms have been redecorated to further improve their appearance. They are of a good size and well furnished to provide a comfortable sleeping area. The lounges are pleasant and homely so that people staying there can use them in comfort. Throughout the home presents as a domestic property of a good standard to accommodate young adults for respite stays. A tour of the premises found it clean and hygienic and, therefore, suitable for its purpose. It has appropriate laundry and hand washing facilities so that standards can be maintained. The registered manager confirmed that all staff receive infection control training at induction to maintain standards. There has been no adverse Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: comments from either families or outside bodies about the standards prevalent in this home. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home recruits, trains and supports staff to a good standard resulting in an effective workforce. Evidence: The last key inspection noted there was a need to obtain more qualifications for staff to meet guidance on this subject. The AQAA stated this had been done and this was confirmed by the visit to the home. Of the four permanent staff, three have either received qualifications at a higher level or are currently undertaking them to further advance their knowledge. The fourth is newly appointed but will be undertaking such a qualification when her probationary period is complete. The registered manager expressed great confidence in the qualities of her staff which she thought was of a high level and leading to improvements in the home. An interview with the senior support worker confirmed a committed and highly motivated approach to the work and this was also confirmed by comment cards received from other staff. These were confirmed by comment cards received from people who stay in the home and their families, all of which were positive about the care being provided with a typical comment being the home look after me very well. The AQAA stated there was a full and responsible approach to the recruitment of staff Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: for the protection of users of its service. The visit to the home, confirmed previous experience that there was very little recruitment material present on site to confirm these practices. It did show however that police checks are being taken and the registered manager was confident that all other procedures are being followed as required. Neither the Annual Service Review nor the review of evidence found any concern with the quality of staff being recruited to the home. The registered manager commented on the improvement to the training of staff resulting from the appointment of a new training officer. This was confirmed by the visit to the home. The senior support worker described the training as very, very good which was shown by her training record which was comprehensive and up to date. Other records seen showed that a full training plan is in place to refresh knowledge in subjects. It also showed that staff are given a thorough and comprehensive induction to the work so that they are well prepared for their role in the home. Comment cards from staff were all positive about the training opportunities available to expand their knowledge. The registered manager stated that she seeks to supervise staff on a monthly basis to provide direction to their work. Staff records seen showed that this was generally the case with any exception due to unforeseen circumstances. Comment cards received from staff confirmed that they felt well supported in the home thus enabling them to be confident in their role. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed in the interests of the safety and wellbeing of people staying there. Evidence: There has been no change to the position of registered manager who both in terms of her qualifications and experience is well suited to this role. An interview with the registered manager showed that she has consistently improved the performance of the home to good effect. She has met the requirements of previous reports positively and speedily to improve the delivery of the service. The interview confirmed that she continues to update her knowledge on a regular basis so that she remains familiar with current practice. An interview with the senior support worker, confirmed by comment cards from staff, show that the home is being well managed for the benefit of people who use the service. Contact with them and their families showed that they had a high opinion of the home and particularly the good standard of communication between the registered manager and families, so that the service is effective. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The AQAA stated that the home has some good elements of a quality assurance system as a means of improving performance. Some of this was confirmed by the visit to the home, including a yearly survey of relatives to ascertain their views on the services performance. The home also joins with another Lifeways home to offer an occasional coffee meeting with relatives to ascertain their views. It also uses house meetings as a method of obtaining views from people who use the service to improve the home. However, one deficit is in the required monthly visit from an outside manager to the home to provide a monitoring of performance. Although this previously has been effective, it recently has fallen into disuse with the result that such an external monitoring system is no longer in place. The registered manager confirmed that arrangements are in place to address this matter quickly and effectively. A tour of the premises found it a safe environment for the care of people staying there. The visit to the home showed there were detailed procedures in place to audit health and safety matters both on a weekly and monthly basis so that safety is reinforced. Documents seen during the visit to the home included certificates confirming the safety of utilities. Fire procedures are being implemented appropriately, including individual reminders to people staying in the home about the importance of these procedures. Training documents seen confirmed that staff are being introduced to health and safety matters on induction and that these are being refreshed so that they are being reminded of their importance. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 39 26 A monthly visit and report 06/07/2009 on the progress of the home must be made. To ensure that full monitoring of its performance is undertaken. 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 The care plans should be reviewed on a six monthly basis so that they remain up to date. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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