Care Home: National Autistic Society, 4 Heath Rise

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What the care home does well Individual plans of care gave very detailed information about people`s preferences and routines and covered people`s full range of needs including there physical, emotional, spiritual and sexual needs Staff are given good information about the best way to communication with people and details about how to support people to manage their anxiety. Each person has long term objectives which detail their aspirations and how they will work towards achieving these. People are given copies of guidelines to help them with specific areas where they need support or guidance. Where needed these are produced in `easy read` formats to make the information more accessible. People who live at 4 Heath Rise are actively involved in the running of their home. Staff described the home as "relaxed, like a proper home." Various information such as the complaints procedure and staff rota are available in an `easy read` format to make the information easier for people with learning disabilities to understand. Individual plans of care contained various guidelines for the people living at the home to help them to be safe such as reminders to charge mobile phones so it can be used should they need it when out. The property provides people with spacious and comfortable accommodation. Discussions with staff and observation of how they relate to the people who live in the home showed a good understanding of people`s needs. What has improved since the last inspection? Individual plans of care contained detailed assessments of any risks that people may face in their day to day lives and how these risks can be minimised without compromising people`s independence. Communal areas of the home have been redecorated. What the care home could do better: The home does not currently regulate the hot water temperatures in people`s bath and shower rooms. This puts people at risk of being scalded. Each person should have an up to date contract which specifies the service that they receive. This should be signed by the person wherever possible. Records of when people had attended or were due to attend health appointments is not always clear.Medication administration records need to detail all medication received into the home so that there is a clear audit trail of medication. All medication administered must be signed for. The storage of medication must comply with the latest guidelines and legislation. Staff should have clear instructions of how and where prescribed creams are to be applied. The carpet in communal areas was stained in places and the dining chairs showing signs of wear and tear. The home has not undertaken any satisfaction surveys to gain feedback from the people who live at the home or other people involved with the service. Key inspection report Care homes for adults (18-65 years) Name: Address: National Autistic Society, 4 Heath Rise National Autistic Society, 4 Heath Rise Wellingborough Northants NN8 5QN     The quality rating for this care home is:   one star adequate 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: Catherine Perrins     Date: 2 0 0 7 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 29 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 29 Information about the care home Name of care home: Address: National Autistic Society, 4 Heath Rise National Autistic Society, 4 Heath Rise Wellingborough Northants NN8 5QN 01933676786 01933676786 joannahughes@nas.org.uk Vanessahalfacre@nas.org.uk National Autistic Society care home 4 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 Additional conditions: 4 Heath Rise care home is registered to provide personal care to male and female service users who fall within the following categories: Learning Disability (LD) 4 Persons accommodated in 4 Heath Rise care home must be diagnosed with an Autistic Spectrum Disorder. That the age range of persons accommodated at 4 Heath Rise care home is 18 to 40 years of age. The maximum number of persons to be accommodated at 4 Heath Rise care home is 4. Date of last inspection Brief description of the care home 4 Heath Rise is a large modern house in a residential area on the outskirts of Wellingborough. It is run by The National Autistic Society and people living at the home need to be assessed as being on the autistic spectrum. 4 Heath Rise is on a quiet road but is close to a main road with a regular bus service to the town centre. People each have their own bedrooms and there is a pleasant, well-used garden area. The minimum weekly residential fee at the time of inspection was 1,361.86 pounds and the maximum is 1,371.30 pounds. Day services are charged separately Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 4 Brief description of the care home and vary from zero to 575.73 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 29 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: one star adequate 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 one star. This means the people who use this service experience adequate quality outcomes. This was an unannounced key inspection which means that we focused on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of three hours was spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: Care Homes for Adults (18-65 years) Page 6 of 29 Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service since the last inspection. Relevant information from other organisations. The inspection visit lasted six hours during the morning and afternoon of a weekday. During the inspection two people were case tracked. This involves looking in detail at all aspects of their care and experiences at the 4 Heath Rise, including looking as their individual plans of care and other records, talking to them and talking to their care staff. Because people with learning disabilities are not always able to tell us about their experiences we also used observations of peoples state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection. The registered manager was present for the inspection. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The home does not currently regulate the hot water temperatures in peoples bath and shower rooms. This puts people at risk of being scalded. Each person should have an up to date contract which specifies the service that they receive. This should be signed by the person wherever possible. Records of when people had attended or were due to attend health appointments is not always clear. Care Homes for Adults (18-65 years) Page 8 of 29 Medication administration records need to detail all medication received into the home so that there is a clear audit trail of medication. All medication administered must be signed for. The storage of medication must comply with the latest guidelines and legislation. Staff should have clear instructions of how and where prescribed creams are to be applied. The carpet in communal areas was stained in places and the dining chairs showing signs of wear and tear. The home has not undertaken any satisfaction surveys to gain feedback from the people who live at the home or other people involved with the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 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. Thorough assessments carried out before people move in mean that they can be confident that the home can meet their needs. Evidence: The home has a statement of purpose and service user guide which provide comprehensive information about the home and the services offered. The service user guide was written in plain English with pictures and photographs but the large amount of information given may make it difficult for someone with a learning disability to understand. Records show that peoples needs are assessed before they move to 4 Heath Rise to make sure that the home is right for them. The two people we case tracked did not have current contracts. The contract for one person referred to a home where he had lived previously and the other person did not have a contract on their records. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: People told us that they were able to visit the home before they moved in to help them decide if it was the right move for them. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that staff have access to comprehensive and updated care plans that reflect the details of the care that they need. Evidence: Each person who lives at the home has an individual plan of care. This contains their care plans and other information that staff need to care for people in the right way. Peoples individual files contained a photograph of them but it was not clear whether they had given their consent for this. Individual plans of care gave very detailed information about peoples preferences and routines, this is especially important for people with autism and ensures that people receive support in a consistent way. Care plans were very individual and covered peoples full range of needs including there physical, emotional, spiritual and sexual needs. Records show that staff are given good information about the best way to Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: communication with people and details about how to support people to manage their anxiety. Each person who lives at the home has long term objectives which detail their aspirations and a plan showing how they will work towards achieving these goals. One person who lives at the home is planning to move on to live more independently having identified where he would like to live. Individual plans of care contained detailed assessments of any risks that people may face in their day to day lives and how these risks can be minimised without compromising peoples independence. Areas covered included using the vacuum cleaner, cooking, staying at home without staff support, shopping and going out independently. All risk assessments had been reviewed within the last twelve months. Records show that people are given copies of guidelines to help them with specific areas where they need support or guidance. Where needed these are produced in easy read formats to make the information more accessible. The registered manager explained that one person liked to have her guidelines printed in various different colours. A spot check of monies held by the home on behalf of individuals showed all money to be accounted for. Care Homes for Adults (18-65 years) Page 14 of 29 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 enjoy active and fulfilled lifestyles both at home and within their community. Evidence: People who live at 4 Heath Rise are actively involved in the running of their home. One person told us that he was going out to do some food shopping so that he could cook tea that evening. The registered manager explained that they have weekly house meetings where people can plan their meals for the week and discuss any other issues concerning the running of the home. A cleaning rota is displayed on the notice board in the kitchen to ensure that people know which tasks need doing when. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: One of the people we case tracked has a job which she has had for several years, another had just finished a college course. There was evidence of people pursuing a range of hobbies and interests both within the home and within the community. One person showed us his computer and CD collection he also talked about his interest in trains and some of the places he had visited recently. One person had passed his cycling proficiency test and was working towards going out on his bike independently. Staff described the home as relaxed, like a proper home. Care Homes for Adults (18-65 years) Page 16 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Incomplete recording means that people cannot be confident that their health needs are being met. Evidence: Peoples individual plans of care gave details of how people preferred to be supported with their personal care, such as whether they liked to bath or shower, how much support they needed and how their privacy and dignity should be respected. Records show that staff have completed an OK Health Check with people to assess whether their health needs are being fully met. There was some evidence of people having input from a range of health and social care professionals such as general practitioners, behavioral specialists, dentists, opticians and chiropodists. In some instances it was not possible to tell when someone had had their last appointment with for example the dentist as records from the previous year had been archived. This meant that it was difficult to determine when their next appointment was due and could result in them missing an appointment. The registered manager explained that one person refused some health appointments Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: such as the chiropodists. Advice was given to make a record of this on the persons file to show that they had been offered the service. The medication administration records were checked. The dates on the sheets used over the last three months were incorrect with the sheets for May, June and July all having May at the top of the sheet. There were some signatures missing from the medication administration record. It was not possible to check if the total number of tablets were correct as the home had not recorded when tablets were received by the home. This means that if where there are signatures missing from the medication administration record it is not possible to ascertain whether the person had their medication or not. An anti biotic for one person was included on the medication administration record although staff informed us that the course had now finished. One person was prescribed cream but there were no instructions to say how and where it should be applied. No-one at the home is currently prescribed any controlled drugs however the storage of medication needs to be reviewed to ensure that the home is able to store any controlled drugs safely and to ensure compliance with the latest requirements of the Misuse of Drugs Act Amendment 2007. This specifies how care homes should store controlled drugs. Controlled drugs are prescribed medicines which some people abuse them by taking them when they have not been prescribed, there are laws and regulations about how these drugs should be stored and administered. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are generally well protected by the homes policies, procedures and practices. Evidence: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. The complaints procedure is available in an easy read format to make the information easier for people with learning disabilities to understand. The manager said that the home has not received any complaints or made any referrals to the Local Authority under the locally agreed safeguarding adults procedure since the last inspection . Staff told us that they have received training on safeguarding adults and knew how to raise any concerns that they may have. Individual plans of care contained various guidelines for the people living at the home to help them to be safe such as reminders to charge mobile phones so it can be used should they need it when out. The home does not currently regulate the hot water temperatures in peoples bath and shower rooms. This puts people at risk of being scalded. Care Homes for Adults (18-65 years) Page 19 of 29 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. People benefit from having a spacious and comfortable place to live. Evidence: 4 Heath Rise is a five bedroomed detached property within a residential estate in Wellingborogh. It provides spacious and comfortable accommodation for the people who live there. Communal areas consist of a large lounge, a dining kitchen and a quiet lounge. The registered manager explained that the property had been redecorated since the last inspection. There were some plants and ornaments in the communal areas to make it feel more homely but the registered manager explained that there were no pictures on the walls because the people living there had different taste and were unable to agree on any pictures that they all liked. The property was generally clean and well maintained although the carpet was stained in several places and some of the dining chairs were in need of repair. Bedrooms have been made personal to reflect peoples interests. Bedrooms seen were spacious. One person told us that he liked to spend time in his room. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The property has an enclosed garden which the registered manager told us that people who live at the home help to maintain. The company employs a handy person who carries out repairs and maintenance work to the property. Care Homes for Adults (18-65 years) Page 21 of 29 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 are supported by a competent staff team who are familiar with their support needs. Evidence: The recruitment of staff is well managed with all of the necessary pre recruitment checks being carried out to ensure that staff are suitable to work with people with learning disabilities. Staff told us that they had an induction when they first started working at the home which included working alongside an experienced colleague to make sure that they had all of the information that they need to do their job in the right way. Staff explained that they attend training courses such as food hygiene, safeguarding of adults and fire safety. Staff told us that their were adequate numbers of staff on duty to support the needs of the people who live in the home and that staff have some time when they can make sure that peoples care plans and other paper work are up to date. A pictorial rota is displayed on the notice board in the hall to ensure that people know Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: which staff are working each day. One person was seen to look at this to check who was working later that day. Records show that staff receive regular supervision with the registered manager, this is used to give feedback on their work and to ensure that they are working to the required standard. Discussions with staff and observation of how they relate to the people who live in the home showed a good understanding of peoples needs. Care Homes for Adults (18-65 years) Page 23 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of the people who live there but the lack of regulation of the hot water is putting people at risk of scalding. Evidence: The registered manager has worked at the home for several years. The registered manager explained that the home has not undertaken any satisfaction surveys this year because they felt that the people who live at the home may not want to complete another survey having completed one for the Care Quality Commission and for the Local Authority. Records show that the necessary safety checks such as fire checks, carbon monoxide checks, checks on the water system and portable appliance testing have all been carried out recently. Discussion with one of the people who lives at the home showed that he was fully aware of what to do if the smoke alarm went off. The home does not have any radiator covers. The registered manager explained that Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: although no formal risk assessment had been undertaken there was no-one currently living at the home who was at risk of falling or having seizures where they could fall against a hot radiator. Records for the temperature checks on the bath, bathroom sink and showers used by the people living at the home show that the hot water is being dispensed at temperatures as high as sixty degrees Celsius. The recommended temperature for safe bathing is around forty three degrees Celsius. The registered manager explained that the home does not currently have any hot water restrictors on any of the hot water taps. The home does have a risk assessment that outlines how people are being protected from being scalded through getting into a hot bath or shower but as some people have en suite bathing facilities and others are given time in the bath alone this risk has not been eliminated. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 20 13 Records must demonstrate that all medication is administered as prescribed. To ensure that people are receiving their medication as prescribed. 31/07/2009 2 20 13 All medication received into the home must be clearly recorded to ensure that there is a clear audit trail of medication received and administered. To ensure that people are receiving their medication as prescribed. 31/07/2009 3 42 13 Steps must be taken to address the risk of scalding to individuals from having no regulation on the hot water taps in the bath and shower rooms used by residents. To ensure that people do not suffer scalds. 05/08/2009 Care Homes for Adults (18-65 years) Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 5 Each person should have an up to date contract which specifies the service that they receive. This should be signed by the person wherever possible. Consent should be sought where ever possible for using peoples photographs in their individual plans of care. Clear records should be kept of appointments with health professionals to ensure that people receive to care and treatment they require. The furniture and carpets should be clean and in good order to ensure people can enjoy a clean, pleasant and safe living environment. 2 3 6 19 4 24 Care Homes for Adults (18-65 years) Page 28 of 29 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). 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. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!