Care Home: Lyndhurst Grove (1)

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What the care home does well The staff are friendly. They meet each person`s needs well.Staff will help to arrange health care when this is needed.The home is well managed. What has improved since the last inspection? The manager still makes regular checks to see everything is going well. What the care home could do better: A lift is needed for people to use the top floor.Care plans need to be up to date.Monthly management visits are needed. Key inspection report Care homes for adults (18-65 years) Name: Address: Lyndhurst Grove (1) Lyndhurst Grove (1) Low Fell Gateshead Tyne & Wear NE9 6AU 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: Lee Bennett Date: 3 0 1 1 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 31 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Lyndhurst Grove (1) Lyndhurst Grove (1) Low Fell Gateshead Tyne & Wear NE9 6AU 01914823104 01914823104 ntawnt.lyndhurst@nhs.net 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) : Northumberland, Tyne & Wear NHS Trust care home 6 Number of places (if applicable): Under 65 Over 65 6 1 learning disability Additional conditions: Date of last inspection 0 4 0 2 2 0 0 9 A bit about the care home A bit about the care home Lyndhurst Grove is a home run by the Care Homes for Adults (18-65 years) Page 4 of 31 National Health Service. 6 people can live here. It is a large house, set in its own garden. There are stairs to some parts of the home. This can make it difficult for some people to get upstairs. Bathrooms and toilets are easy to get in and out of. Everyone has there own bedroom. Nobody has to share. There is a car here for people to use. Care Homes for Adults (18-65 years) Page 5 of 31 This means people can get out and about. Care Homes for Adults (18-65 years) Page 6 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 31 How we did our inspection: This is what the inspector did when they were at the care home This is what the inspector did when they were at the care home The Inspector talked to the people who live at the home. The inspector looked documents that have to be kept. He looked at: Care plans. Staff files. Care Homes for Adults (18-65 years) Page 8 of 31 Medicine records. Some of the homes policies and procedures. (Policies are rules about how to do things. Procedures tell people how to follow the rules.) The inspector looked around the home. This was to make sure it was safe and comfortable. What the care home does well Care Homes for Adults (18-65 years) Page 9 of 31 The staff are friendly. They meet each persons needs well. Staff will help to arrange health care when this is needed. The home is well managed. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 10 of 31 The manager still makes regular checks to see everything is going well. What the care home could do better A lift is needed for people to use the top floor. Care Homes for Adults (18-65 years) Page 11 of 31 Care plans need to be up to date. Monthly management visits are needed. 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 Lee Bennett St Nicholas Building St Nicholas Street Newcastle upon Tyne Tyne and Wear NE1 1NB 01912333300 Care Homes for Adults (18-65 years) Page 12 of 31 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 13 of 31 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 14 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed assessments of need are in place before a persons admission, but are not updated regularly and reflected in care plans. Clear and up to date information can help make sure the home and the staff team can meet peoples identified needs. Evidence: Before a person moves to a care home they are entitled to have an assessment of their needs carried out, either by a social worker or a health care worker, such as a nurse assessor. This person is commonly known as a Care Manager. Even when a person pays for their own care, they are still entitled to such an assessment. All of the people moving here have their care arranged by Social Services. Nobody has come here by private arrangement. The manager of a care home must also obtain information about those people who would like to come here. This will include a copy of the assessment, and a summary care plan written by the care manager, which explains how each persons needs are to be addressed. This is to make sure their needs are looked at and then can be properly met. All of the people living here have done so for some time now, with the last person moving Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: here four years ago. Before these people moved here information was obtained from a social worker to ensure that their needs could be properly met at the home. This is so the manager had sufficient information about each person, and could make a judgment about whether the staff had the right skills and the home was physically suitable for the people concerned. The assessments provided by social workers include information about diversity needs, such as those relating to disability, gender, race and culture. For example, where people have particular religious beliefs, there attendance at church is assisted where necessary. After a person moves here their needs are periodically reviewed and if necessary reassessed, although it is some time since this has been done, even though some peoples needs have increased quite significantly over the past year. Nevertheless, there has been some input from other health professionals, such as the occupational therapist and Speech and Language Therapist. These health professionals has provided guidance for staff to follow, but this has yet to be translated into updated guidance in individual care plans. For example, one person has had their eating and drinking needs looked at. Guidance was offered to ensure staff minimised distractions at meal time, monitored how much fluid was being consumed and to introduce specific exercises. We could see no evidence of how this had been followed through. There is clear information available about the home and the terms and conditions about each persons stay. This has been done in an easy read format, that includes picture prompts. This is so people are kept well informed about what it is like to live here. Care Homes for Adults (18-65 years) Page 16 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are supported to make their own decisions, but care is not well planned, as written plans are not up to date. Up to date information is important in ensuring that both service users and staff are well informed about what care is to be offered. Evidence: To help guide the care that staff offer to the people living here, a care plan file is compiled. All of the people living here have had one developed. These are all written up, evaluated and reviewed by the manager and a key worker; a member of staff who works with a named service user and takes a lead on the planning and delivery of care. We found that most of these documents have not been reviewed or updated for over a year. This means that where peoples needs have changed, and where medical advice has been offered, this has not be reflected in the care plan guidance. The care files contain extensive and detailed information on each persons needs, and are written in a person centred way. The files themselves are poorly organised. The care practice that we observed generally reflected the guidance in the care plans, although some aspects need to be updated, particularly in respect of mobility, diet and eating. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: Closely linked to care planning arrangements are risk assessments. Again, these are written up by a key worker when there is an identified area of risk, either to the service user, or to others by that persons behaviour or needs. They follow a standardised format, and detail the area of risk, consider the benefits of certain risks being present, and outline how unnecessary risks are to be managed. We found that areas of risk were being documented for most aspects, but where needs had recently changed will need to be reviewed. Both care plans and risk assessments are a formal way of documenting decisions about important matters affecting a persons care and lifestyle. There are also occasional group meetings held. The people living here are clearly able to express their views and (sometimes with guidance) come to decisions about the things that affect them. Where decisions are taken by others that may involve a deprivation of liberty, or require actions in a persons best interests, current procedures under the Mental Capacity Act are followed. Some people also have advocates to support them. These are people specifically employed to befriend and then speak up on a persons behalf. There is currently a longstanding review of this service being held by Gateshead Council, and the views expressed to us are that the people living here wish to remain so, and to continue living as a group. We received several positive comments about the service people receive here. People living here told us: - They are able to make decisions about what they do. - Staff treat them well. - Carers listen to and act upon peoples comments and requests. - Staff are informed about how peoples needs are to be met. Specific comments included: - Provides a caring family orientated home. Is adaptable to changing needs of service users. Always pleasant atmosphere for service users. - Good in managing clients and following advice and guidelines. Care Homes for Adults (18-65 years) Page 18 of 31 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. The people living here are assisted to spend their time in an active and fulfilling way, at a pace reflective of their needs. This can help promote each persons sense of wellbeing. Evidence: On the day of the inspection, some of the people living here were spending their time at council day services. One person was having a day off, and was relaxing at home. Another was at home poorly. The people living here lead an active lifestyle, although these are beginning to take on a more relaxed pace as people get older or have become more frail. Several still attend day services through the week, and all go out and about with staff, and often meet up with family and friends. They also have their own vehicle to help get further afield. Some of the people living here told us about the things they like to do, the holidays they have been on, and their plans for things to do this year. Some of the people here told us they have been on two Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: holidays this year, and how they had enjoyed these. People said: - Its lovely here. I go on nice holidays and to the theater. - The home offers a pleasant and safe environment for both service users and the staff who work here. It offers opportunities to engage and participate in their local community and is well managed. As well as going out and about or being occupied whilst in the home, contact with friends and relatives can affect the quality of life enjoyed by people. Most people living here have regular family contact, and visitors are made welcome. One persons family also help their relative to go to church each weekend. We were told by the people living here. - I like living here with my friends. - Enable me to spend time with my friends and family. As well as having rights to keep up family contacts and to lead a varied and fulfilling lifestyle, the people here retain rights around how they are helped, and what staff do when they put themselves at risk of harm. To help meet these rights there is some guidance in care plans and risk assessments. Where decisions are taken on behalf of people, these are well planned, involved people to speak up on behalf of service users (including advocates) and the information in this respect is largely up to date. Furthermore, staff were able to explain to us clearly the individual needs of each person living here, any risks they may face, and how these are managed. Meals form an important part of peoples daily routine and lifestyle, and are normally taken as a group as the people living here usually get on well. There are two separate dining areas, although one dining room is temporarily being used as a bedroom, pending alterations being made here. Mealtimes are an important time for people to talk about their day, and share their experiences with staff. Twp people specifically said to us, I like the food. The dietary needs of each person are detailed in their care plans, and there is a record kept of meals planned and provided. Where help and prompting is needed staff were able to explain the help they offer, with clear guidance from health professionals also being available in each persons care plan file, but this needs to be more up to date in individual care plans. Care Homes for Adults (18-65 years) Page 20 of 31 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. Each individuals personal care and healthcare needs are well supported band privacy ensured. Evidence: The people living here have their personal and healthcare needs outlined within their case files. Their needs are supported and met, where appropriate, in private. Specialist support and input has been sought and obtained where necessary, and multi-disciplinary input (such as that from the Speech and Language Therapist, or with diet and nutrition) is made available. As well as making sure healthcare advice is sought, the registered manager, and other staff in the team, help the people living here to access healthcare treatment. This is so people get the help and healthcare they need to keep well. The results of healthcare visits and routine monitoring is recorded within each persons care file, though not in a consistent manner. Clear recording can help ensure that staff follow any advice and guidance that has been made by the healthcare professional. Linked to these health and personal care arrangements is the support given with medication. Due to their levels of need, service users are not able to administer their own medicines, and designated staff will help in this area. The staff here have had medication Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: administration training (the safer handling of medication course). This has been supplemented by in-house guidance and competency testing. The medicines themselves are stored in a locked cupboard to keep them safe. There is only a small amount of loose stock, the rest being held in a monitored dosage system. This is where tablets are placed into a blister pack system by the pharmacist. Once given out staff write down who has had what medicine on printed administration records. A brief check of the medicines used here was carried out by us. All of the medicines we looked at were properly accounted for. Care Homes for Adults (18-65 years) Page 22 of 31 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. Clear systems help protect people from neglect, abuse and self-harm. Evidence: A clear, written complaints procedure is available at the home. There have been no complaints reported to us since the last inspection. The people living here are aware of how to raise concerns and complaints, both in the home and to external agencies, such as Social Services and ourselves. The people living and working here all told us that they knew how to make a complaint, and how to raise concerns, should they have any. The staff here have also received training on adult safeguarding and abuse awareness matters. Both the care providers and the local councils adult protection procedures are available here for staff to refer to. Appropriate actions are taken to protect people from harm. Care Homes for Adults (18-65 years) Page 23 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lyndhurst Grove provides a homely and comfortable environment, but further adaptations are needed to meet peoples current and changing needs. Evidence: Lyndhurst Grove is an adapted, detached house, that allows for easy access for people who are physically frail or disabled to the ground floor only. As there are stairs to the first floor access here is limited. As a result of one persons changing needs, a temporary arrangement where they used the dining room as a bedroom was agreed with us. However, it is nearly two years now that this has been the case, and adaptations (such as a through floor lift) need to be progressed to maintain access to all parts of the home for this person. We have been told that this will now be carried out in the New Year. We will monitor this to ensure this is the case. As has been previously reported, the people living here are becoming less active and more frail, so such adaptations will enable them to remain here much longer than might otherwise be the case. Overall the home is domestic in style, and each persons bedroom has been personalised to suite their tastes. The home is clean throughout and there is good odour control. Lyndhurst Grove is a comfortable home, and the people living here appear relaxed and at ease in their surroundings. Care Homes for Adults (18-65 years) Page 24 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are supported by a competent and qualified staff team. Evidence: There have been two new staff member recruited here since the last inspection. We were not able to see the staffing records as these are held elsewhere, however this has been agreed with us, and are periodically checked on a random basis. These checks have found that Northumberland, Tyne and Wear NHS Trust has robust pre-employment checks in place, including checks for criminal convictions, against the Protection of Vulnerable Adults List, and reference checks from previous employers. Overall staffing levels and team members have remained reasonably stable and at the time of the inspection, three quarters of the support staff were qualified to NVQ level 2 in care [or higher]. The staff here also undertake periodic training on topics relating to safety and care. We found that all staff had received a one day mandatory course, covering topics such as first aid, health and safety, fire safety and moving and handling. Training is one of the topics discussed at each staff members supervision session. These are one to one meetings that are held between a staff member and manager to discuss their performance, training needs, personnel and personal matters. Actions are agreed where necessary. These occur on a regular basis, to allow staff to feel supported and informed about developments at the home. Care Homes for Adults (18-65 years) Page 25 of 31 Care Homes for Adults (18-65 years) Page 26 of 31 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. Service users benefit from a well managed home, where quality and health and safety matters are regularly checked. This can help ensure the service remains focused on the needs and safety of the people who live here. Evidence: Lyndhurst Grove is overseen, on a full time basis, by the registered manager. She is supported by a deputy manager. The registered manager is qualified to NVQ level 4 in care and has also obtained an NVQ in management. The staff here told us that they are well supported by the homes manager. They said: - Manager is very supportive. Very friendly atmosphere. - Although the service is well run by the home manager, better support needs to be given by locality managers and above. As well as ensuring her own knowledge and practice remains up to date, the registered manager undertakes a number of quality checks and audits to ensure the standard of Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: care is up to current good practice levels. More senior managers also carry out monthly inspections, but these have been infrequent. Just as the quality of the care provided is checked, so are matters affecting health and safety. Therefore regular checks on the building are carried out, water and fridge / freezer temperatures are monitored, and working practices that could present a risk are looked at, and safe ways of working (for instance by the use of lifting aids) introduced. There were no hazards to health and safety observed, other than the need for a lift to reduce the risk presented to people with epilepsy from using the stairs. The chemical information sheets obtained to inform staff of what to do if they have an accident with a chemical product are up to date. Care Homes for Adults (18-65 years) Page 28 of 31 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 1 29 23 Suitable adaptations must be 26/06/2009 made to the home. This is to ensure service users can access all shared areas of the home and their own bedrooms. This is to ensure service users can access all shared areas of the home and their own bedrooms. Care Homes for Adults (18-65 years) Page 29 of 31 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 need to be kept under regular review, and updated to reflect each persons current needs and the guidance offered by healthcare professionals. 29/01/2010 This is so everyone is fully up to date with how each persons needs are to be met. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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