Care Home: Mendip House

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What the care home does well Mendip House provides a calm and homely environment. Many people who live at the home are unable to fully express themselves verbally. The home uses a variety of communication methods to ensure that people are able to make genuine choices and are fully involved in the running of the home. The home is effectively managed, there is a clear staffing structure ensuring that there are clear lines of responsibility and accountability. Staff spoken with said that there was good communication and teamwork in the home. Staff working at the home receive a good induction programme and there are opportunities for ongoing training in health and safety issues and other subjects relevant to the work they do and the people they support. People have access to a wide range of social and leisure activities according to their interests and abilities. Risk assessments are in place to ensure that people are able to access a wide range of activities with minimum risk. What has improved since the last inspection? Since the last inspection the home has continued to expand the communication methods in the home to make sure that people can be fully involved in decision making. People living at the home are now part of the recruitment process and are able to meet with, and offer their views about, prospective new staff. The person centred plans now include healthcare plans which are very individual and meaningful to the person. The home has also ensured that people are offered a choice about the doctors surgery that they use. A monthly newsletter to families has been created to to keep people up to date with things happening in the home. What the care home could do better: Mendip House continues to offer a good service to the people who live there. At the time of this inspection hot water temperatures in one bathroom exceeded the recommended temperature and potentially posed a scalding risk. The bathrooms in the home continue to be sparse and unwelcoming. There is a modernisation plan for the refurbishment of the home which is part of the Somerset Court total modernisation plans which will up grade all accommodation. Key inspection report Care homes for adults (18-65 years) Name: Address: Mendip House Somerset Court Harp Road Brent Knoll Highbridge Somerset TA9 4HQ     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: Jane Poole     Date: 1 8 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Mendip House Somerset Court Harp Road Brent Knoll Highbridge Somerset TA9 4HQ 01278760555 01278760747 janet.smith@nas.org.uk Vanessahalfacre@nas.org.uk National Autistic Society care home 9 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) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home Mendip House is a large detached bungalow situated in the extensive grounds of Somerset Court, which is owned by the National Autistic Society who remain the registered provider. As part of Somerset Courts Modernisation Programme each previous accommodation area that formed Somerset Court, has now become a separate registered service. Mendip House is registered to provide care to up to 9 people. 9 9 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 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: 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: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for people and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out by one inspector. We, the Commission were able to talk with people living and working at the home, observe care practises, tour the building and view records. We were given unrestricted access to all areas of the home and all records requested were made available. Care Homes for Adults (18-65 years) Page 5 of 27 The manager completed an Annual Quality Assurance Assessment (AQAA) This was completed to a very high standard and gave details about the home, its achievements and plans for the future. The AQAA demonstrated a commitment to ongoing improvement and involvement of people who live at the home. Care Homes for Adults (18-65 years) Page 6 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 7 of 27 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. Anyone wishing to move in has their needs assessed to ensure that Mendip House is the right place for them. People have opportunities to visit the home before deciding to move in, to ensure that it meets their expectations. Evidence: The home offers a specialist service to people who have autism and all staff receive ongoing training in this area to ensure that their practise is up to date and reflects current good practise in this field. There is a statement of purpose and service user guide that is written in symbol and pictorial format to ensure that it is meaningful to the people who live at the home. Since the last key inspection one new person has moved into the home. Their needs were fully assessed by professionals outside the home to ensure that Mendip House was suitable to meet their needs. The new person had opportunities to spend time at Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: the home before deciding to move in. This gave them time to meet staff and people living at the home to see if it met their wishes and expectations. The manager gave evidence that she looks at the needs of any new person and their compatibility with the people already living at the home before offering a placement. Care Homes for Adults (18-65 years) Page 11 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. Care plans are very personal to the individual and give clear guidance to staff about how people wish to be supported. The home is very committed to ensuring that people are able to make decisions and use a variety of communication methods. Evidence: Many of the people who live at the home are unable to fully express themselves verbally. Therefore the home uses a variety of methods to communicate with people to ensure that they are able to make choices and decisions about their day to day lives. Photographs and pictures are widely used to ensure that people are able to make choices about the activities that they take part in, the food that they eat and the decor in the home. Staff spoken with and observed during the inspection demonstrated a good knowledge of individuals abilities, likes and dislikes. Everyone now has a person centred plan which they are fully involved in creating. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Again this is in a picture and written format which makes it personal to the individual. Two care plans were looked at in detail and these gave very individualised information about the person to ensure that they received support in their chosen manner. Care plans gave details of peoples daily routines, the level of assistance required and the activities that they enjoy. Significant events are recorded and these are summarised at the end of each month. Risk assessments are completed to ensure that people are able to take part in activities with minimum risk to themselves and others. One care plan contained an enhanced risk assessment that had been put in place for the persons day to day safety and well being. Control measures put in place included making additional staffing available. Care Homes for Adults (18-65 years) Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to take part in a wide range of activities according to their abilities and interests. People are supported to keep in touch with friends and family. The menu in the home is in line with peoples preferences and health living guidelines. Evidence: Daily routines in the home are based around individual needs and choices. Peoples preferred routines are recorded in their care plan. The home demonstrates a genuine commitment to ensuring that people have opportunities to develop their independent living skills and take part in leisure activities at the home and in the wider community. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: Day services are provided on the Somerset Court site and enable people to take part in a wide range of activities. Each person has a in house day during the week when they spend time in the home developing their independent living skills and accessing the community in line with their needs and wishes. The home is set in a rural location and not on a public transport route. They have one vehicle and access to others to ensure that people are able to access local facilities. Staff stated that they arrange activities and outings according to the individuals interests. Photos show that people living at the home take part in a variety of activities including cycling, walking, going to the theatre, attending football matches, swimming and shopping. People living at the home said that special occasions are always celebrated with parties or meals out. People living at the home attend local clubs according to their interests. Staff assist people to keep in touch with friends and family. People said that they enjoy days out and holidays with family. The AQAA states that they now send a monthly newsletter to families to keep them up to date with what is going on in the home. Staff in the home work flexibly to ensure that people are able to take part in evening activities and social functions. Key workers support people to have holidays away from the home. The home operates a six week menu that has been developed in line with peoples preferences and healthy living guidelines. The main meal is in the evening with people having a lighter meal at lunch time in the Somerset Court canteen. There are two options on the menu at each meal. There is a book with pictures of all meals so that people are able to make a choice. On Saturday people take turns to choose the main meal of the day. People living at the home assist with meal preparation and food shopping. People living and working at the home all eat together creating a pleasant social occasion. Everyone asked said that the food was always good. 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. People living at the home have access to healthcare professionals according to their individual needs. Medication policies and procedures promote safe practise. Evidence: Care plans give details of the level of assistance that people require with personal care and their daily routines. All rooms have wash hand basins and there is shared bathing and showering facilities available for everyone to use. The home employs both male and female support workers to allow people to have a choice about the gender of the person who assists them with intimate personal care. The home are currently working on person centred health care plans, which are again being developed in consultation with people living at the home and their representatives. All staff receive training in the Mental Capacity Act and the manager gave evidence of how this had been used to ensure that someone received medical attention in line with Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Best Interests guidelines. There is evidence that people have access to health care professionals according to their individual needs. People are supported to attend appointments outside the home and all appointments and their outcomes are recorded. Evidence was seen that people have access to healthcare professionals including GPs, dentists, speech and language therapists, psychologists and chiropodists. One person has recently been assessed by a physiotherapist and all staff are assisting them in a new exercise routine to promote mobility. Since the last inspection the home has made sure that people have choice about the doctors surgery that they are registered with. The home uses a Monitored Dosage System for medication and only staff who have received specific training administer medication. It was noted that all medication is signed for when it enters the home and when administered or refused. This gives a clear audit trail. There are two sets of printed Medication Administration Records (MARs) one is signed by the member of staff who administers and one signed by another staff member as a witness. MARs also include information about each drug used, including side effects. During the inspection one person requested pain relief that was prescribed on an as required basis and this was given at the time of their asking. There are suitable safe storage facilities for medication. 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 home has taken reasonable steps to minimise the risks of abuse to anyone living at the home. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. All staff receive training in the protection of vulnerable adults as part of their induction training. Staff spoken with during the inspection were aware of the whistle blowing procedure and the ability to take serious concerns outside the home. There is information in the office about the local protocol to follow if an allegation of abuse is made. There is a complaints policy that is written in an accessible format and this has been made available to everyone living at the home. No complaints have been received by the home or the Commission since the last inspection. It was observed that people living at the home have unrestricted access to their personal rooms and all communal areas. Recruitment records demonstrate that no new staff commence work in the home until appropriate checks have been carried out. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Mendip House provides a comfortable environment and people are able to have input into its decoration. Bathrooms are sparse and unhomely. Evidence: Mendip House is part of the Somerset Court complex. There are 5 registered care homes, day service facilities and administration support on the site. There are also some shared facilities such as a canteen and laundry. The home is a single storey building with 8 single bedrooms and 1 self contained flat. The home was built some years ago and there are now plans for its redevelopment to improve the facilities available for the people who live there. There is a large communal lounge/diner that everyone has access to and a small garden area with seating. People also have access to the extensive grounds surrounding the home. The home is planning to redecorate the lounge and people are being consulted on colour schemes. Records of residents meetings showed that consultation has begun. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Bedrooms are for single occupancy and some people living at the home were happy to show their rooms. All had been personalised to reflect the tastes and needs of the individual. There are two bathrooms and one shower room. One bathroom has an assisted bath in line with the needs of a person living at the home. Bathrooms are sparse and unhomely. The home regularly tests the temperature of hot water in the bathrooms and it was noted that on several occasions it has been above the recommended temperature. This issue had been highlighted but has not been successfully remedied. Bath water tested on the day of the inspection was 48 degrees which is above the recommended 44 degrees Centigrade. This potentially places people at risk of scalding and needs to be rectified. The main laundry is located in the main Somerset Court building and is shared by all homes on the site. Mendip House has a washing machine in the kitchen that some people use for their personal laundry when meals are not being prepared. All areas of the home seen were reasonably maintained and clean. 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. People living at the home are supported by a committed and well trained staff team. Recruitment procedures minimise the risks of abuse to the people who live at the home. Evidence: The home employs 17 support workers, 11 (65 ) have a National Vocational Qualification (NVQ) in care at level 3. A further two people are registered to begin this qualification. All new staff undertake a 4 week induction programme when they begin work. Staff spoken with said that the induction programme was very good and gave them the knowledge they needed to commence work with the people who live at the home. New staff stated that the existing staff team were very welcoming and they felt that they had been very well supported. There is an ongoing training programme to ensure that all staff have up to date knowledge. Staff were very happy with the training available and stated that they had access to training arranged by The National Autistic Society and by outside training companies. Records of staff supervision sessions demonstrated that staff are able to Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: highlight the areas that they feel they need extra support or training in. Throughout the inspection it was observed that staff interacted constantly with people living at the home. There is a very warm and friendly atmosphere and people appeared extremely comfortable with the staff who supported them. Staff spoken with were very enthusiastic about their jobs and showed at commitment to providing a high quality personalised service. The recruitment files of 4 newly appointed members of staff were seen. These demonstrated a robust recruitment procedure that includes obtaining written references and carrying out appropriate checks. All prospective staff are interviewed and if successful are invited to spend time in the home interacting with the people before a position is offered. People living at the home are able to ask prospective staff questions and feedback their views to the manager. This ensures that people living at the home are fully involved in the recruitment of new staff. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is effectively managed and there is a commitment to seeking the views of the people who live there. There are systems in place to monitor the quality of the service offered. Evidence: There is a clear staffing structure in the home meaning that there are clear lines of accountability and responsibility. The registered manager is Janet Ceylan, she has many years experience of working with people with autism and learning difficulties. She has the appropriate skills and qualifications to effectively manage the home. The AQAA was completed to a very high standard and gave clear evidence that the home involve people in all aspects and are constantly looking at ways to improve the service offered. Staff spoken with stated that the management in the home is open and approachable. They stated that the manager works alongside them to offer support and guidance. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The home makes contact with the Commission to share information and inform of significant events or incidents. Throughout the inspection it was apparent that everyone works hard to seek the views of the people living at the home. Communication methods are tailored to each individual and the home is putting in place communication passports for everyone to ensure that they are able to influence the running of the home. There are regular meetings for people living and working at the home. There is also a suggestion box. To monitor the quality of care and facilities the home carries out monthly audits and there are monthly visits by the provider. Records of these audits and visits are maintained in the home and were viewed during the inspection. They demonstrated that the home is pro active in implementing new ideas and seeking the views of people living at the home and other interested parties. The National Autistic Society (NAS) acts as a corporate appointee for many of the people who live at the home. Each person has a personal bank account and small amounts of money are kept in the home. People can access their personal money at any time. Records are maintained of all monies kept and receipts are maintained for purchases. All staff receive training in health and safety matters such as food hygiene, moving and handling and first aid. A fire risk assessment is in place. It was noted that fire alarms were not being tested weekly in line with the homes policy and one member of staff had not received training in fire safety for over a year. Assurances were given that this person would receive training before their next shift. As previously stated one hot water outlet exceeded the recommended temperature which potentially places people at risk of scalding. All areas of the home are reasonably maintained and there is evidence that equipment is regularly serviced. Up to date certificates of registration and insurance are displayed in the home. 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 42 13 (4) [a] the manager must ensure that hot water temperatures in communal areas do not exceed 44 degrees Centigrade. To minimise the risk of scalding to people who live at the home. 31/08/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 27 42 Bathrooms would benefit from being made more homely and inviting. The testing of fire alarms and training of staff in fire safety should be undertaken in line with the homes policy of weekly alarm tests and 6 monthly staff training. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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