Care Home: Park Lodge Care Solutions

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What the care home does well Park Lodge offers an attractive, homely and well maintained environment for the people who live there. People have had their individual needs and wishes recorded in a plan of care that is kept under regular review, they have access to good healthcare services and the home is working with a variety of community professionals. There are activities and outings that provide interest and personal development and people told us that they enjoyed going out into the community, seeing their families and friends and they enjoyed the choice of food being provided. The staff team are receiving updated training and tell us that they are well supported and we saw that there was a good rapport between service users and the staff on duty. What has improved since the last inspection? The four Requirements made at the last visit have been fully met. There are clear care plans in place that guide the staff team to the physical, emotional and social needs of service users and there is clear guidance in place for the staff team to follow. The system for administering and recording medication has been reviewed and updated and staff have received further training and support. Where there are plans in place for dealing with unique behaviours such as the use of restraint, staff training has been carried out, there have been multidisciplinary agreements recorded and there is detailed guidance in place for the staff team to follow. Records have been reviewed and updated and there is a comprehensive system in place that is easily monitored to manage service users` monies. What the care home could do better: In order to ensure that the positive changes made to the quality of care being provided in the home are consistent and embedded in practice, an experienced and competent manager must be recruited and the registered provider should continue to recruit to replace the staff currently seconded to the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Park Lodge Care Solutions 24 Goffs Park Road Southgate Crawley West Sussex RH11 8AY     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: Annie Taggart     Date: 0 1 1 2 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 26 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 26 Information about the care home Name of care home: Address: Park Lodge Care Solutions 24 Goffs Park Road Southgate Crawley West Sussex RH11 8AY 01293548408 01293426831 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Park Lodge Solutions Ltd care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 10. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Allied Care Ltd has taken over the home, operating as Park Lodge Care Solutions and the home is registered to accommodate up to ten service users with a learning disability. The accomodation, which is a large two storey, detached Victorian house is situated in a residential area of Southgate, Crawley. There are ten bedrooms, with accommodation provided over two floors, this includes a good range of communal areas and a garden and the property is within reach of bus and train services The Registered Provider is Park Lodge Care Solutions Ltd and the Responsible Individual is Mr Aslam Dahya. There is no registered manager and the post is vacant. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 10 0 2 0 7 2 0 0 9 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: In order to plan for this inspection visit we looked at the last inspection report and also at an improvement plan that was required to be sent to us by the home following the last key inspection. Surveys were sent to service users, staff and other people involved with the home, none were returned. The unannounced visit was carried out at 11.30am on Tuesday 1st December 2009 and lasted for four and a half hours. During the visit we met with six of the eight service users currently living in the home in communal areas and in their private bedrooms and we also spoke with five members of staff. Three care plans and all supporting documentation such as risk assessments, care plans and daily records were tracked and all were current and in good order and we looked at the systems for ensuring that people received good healthcare support and were receiving their medication in a safe manner. Care Homes for Adults (18-65 years) Page 5 of 26 We looked at evidence of staff recruitment processes and at staff training and development records and we saw evidence that staff meetings and parents meeting are held. Records for the running of the business including complaints and concerns, Regulation 26, providers visits, accident and incident recording, quality assurance, fire records and service users money management were also tracked. Feedback following the visit was given to the area manager, Mrs Jenkins who is currently overseeing the home in the absence of a registered manager. Care Homes for Adults (18-65 years) Page 6 of 26 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. 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 7 of 26 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 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had their individual needs assessed before coming to live in the home and there is a process of re-assessment and review being carried out in order to ensure that the home is still meeting peoples needs. Evidence: At the last inspection visit these Standards were found to be met and no new service users have recently been admitted to the home. From looking at records and care plans we saw that there is a process of reassessment and review being carried out in order to ensure that the home is meeting peoples individual needs and we saw that families and other professionals such as care managers are involved in the process. Care Homes for Adults (18-65 years) Page 9 of 26 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 have their individual needs and wishes assessed and recorded in a detailed plan of care. There is clear guidance in place for the staff team to follow, risks are assessed and recorded and plans are kept under regular review. Evidence: At the last inspection visit we found that care plans did not clearly record the individual and changing needs of people and had not been regularly updated. At this visit we found that for each person living in the home there is a detailed plan of care in place that clearly guides the staff team about the way each person wishes and needs to be supported. We tracked the care plans for three people and saw that there was a background history for each person and the plans gave comprehensive information about peoples healthcare needs, personal care preferences and individual communication requirements and they addressed physical, emotional and social needs. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Many of the people living in the home have complex needs and individual communication methods and we saw that the home has been working with speech and language therapists and other professionals in order to ensure that the staff team are aware of how to support people. In the care plans we saw some pictorial guidance for service users and for some people individual pictorial communication books are in place. Care plans showed us that risks are assessed, recorded and kept under regular review and that other professionals and families are involved in the process. From looking at records we saw that where there might be restrictions on people for their safety, other professionals such as care managers are involved in the process and we saw that applications had been made for advice from the Deprivation of Liberty team (DOLs) Of the three care plans that we saw, two had been reviewed in October 2009 and the other in November 2009. Care Homes for Adults (18-65 years) Page 11 of 26 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 activities and outings to provides them with interest and personal development, they have access to their local community and are offered a choice of home cooked meals. Evidence: Each person has a daily living and needs assessment in place and this details peoples likes and dislikes, hobbies and interests and guides the staff team how people like to be supported. From looking at daily activity plans and daily records we saw that some people attend day care facilities or local colleges and one person is supported by staff while they are at college. People go out for meals and for coffee and snacks, they attend clubs and social activities and we saw that swimming and trampolining are also attended. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: In-house activities are also carried out and we saw that there is arts and crafts materials, games and a pool table and people also help in the house laying tables, helping with the washing up, caring for the homes rabbit and going out to help with the food shop. During the visit we saw that two people were going to the cinema with a member of staff and when tracking care plans we saw that this had been an identified goal for the month for one of the people. From looking at menus and food records we saw that people are offered a choice of menu and that their likes and dislikes are recorded. Specialist diets are catered for and we saw that the home is working with dietitian and speech and language services in order to meet peoples individual needs. We saw that service users are involved in cooking and making their own breakfasts and snacks and there are pictorial prompts on the kitchen cupboards to aid their independence. People told us that they enjoyed their meals and also liked to go for meals out or to see their families. Care Homes for Adults (18-65 years) Page 13 of 26 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 have their physical and emotional healthcare needs assessed, recorded and kept under regular review. The home is working with a variety of healthcare professionals in order to meet peoples individual needs and medication is being well managed. Evidence: Each service user has a recently updated Health Action Plan in place that identifies both their physical and emotional healthcare needs and details how this is going to be met. From looking at records we saw that all areas of peoples needs identified in the plans had clear guidelines in place for the staff team to follow and they recorded how the person liked to be supported. At the last inspection visit there were concerns identified that showed that not all peoples individual needs were being met. At this visit we found that peoples needs had been re-assessed and the home is working with a variety of healthcare professionals. Records showed us that this included, local doctors, district nurses, Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: speech and language therapists, the positive behaviour team, dietitian and nutritional services and the local learning disability community team. We also saw that there was clear guidance in place for the staff team to follow for supporting people with unique behavioural communication methods, staff had been trained and there was pictorial guidance in care plans. At the last visit a requirement was made regarding the management and recording of medication, at this visit we found that the system had been reviewed and updated and a new system has been put in place. A staff member showed us that the amounts of medication kept in the home has been decreased and a monitored dose system of administration is in use. There are clear guidelines in place for the staff to follow about what medication people take, what it is for and what the side effects might be. Body charts are used to show the staff team where creams should be applied and there is a protocol agreed with a doctor for the use of homely remedies. There were no gaps in signing in the medication recording sheets, (MAR) and we saw that the homes new system of a witness also signing the forms had been adhered to. Care Homes for Adults (18-65 years) Page 15 of 26 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. There are polices and procedures in place to deal with complaints and concerns and the homes working practices are designed to protect people from risk of abuse or harm Evidence: There are polices and procedures in place regarding the home dealing with complaints and concerns and we saw that there is also an accessible form for service users using pictures and symbols. We looked at the complaints book and this showed us that all complaints and concerns are recorded, there is the date when they were investigated and when the outcome was fed back to complainants. From looking at training records we saw that the staff team have training in protecting people from risk of abuse or harm (Safeguarding). We spoke with all of the five staff on duty during the day and asked them what they would do if they suspected any abuse and they all said that they would report it to a senior manager straight away. At the last inspection visit we found that there were risks to service users by restraint being used without the correct training and guidelines in place. At this visit we found that the staff team had attended the relevant training and clear, agreed protocols and audits were in place. Care Homes for Adults (18-65 years) Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean, comfortable and homely environment for the people who live there. There is a programme of redecoration and refurbishment underway and infection control issues are being addressed. Evidence: Park Lodge is a large detached house in a residential area close to local amenities and public transport. The accommodation comprises a large lounge, dining room/activities room and a conservatory, with a pool table and other equipment for people to use in leisure times. The kitchen has pictorial prompts on the cupboards to assist people when making their own snacks and drinks. There is an enclosed, well maintained garden to the rear and off road parking for several vehicles to the front of the building and there is also a minibus available to assist people to access the community. Communal areas were bright, clean and attractively furnished and they were comfortable and homely with plenty of room for people to move about freely. Peoples private bedrooms were bright and well decorated and they were personalised with peoples own belongings and showed evidence of their hobbies and interests. Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: There is a programme of redecoration underway and during the visit a maintenance person was decorating and also carrying out maintenance checks such as hot water temperature checks. The record book showed that fire checks are regularly undertaken the latest recorded being 22/11/2009 and the last staff fire training recorded was 9/9/2009. Infection control issues are addressed and we saw that staff were using hand gels, gloves and aprons and an infection control update in training had been carried out on 30/9/2009 Care Homes for Adults (18-65 years) Page 18 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recent changes in senior staff at the home have caused some disruption to the standard of care being provided. New staff are now in place and people are currently being supported by a competent, caring and well supported staff team. Evidence: Staffing rotas showed that the staffing structure has recently been changed to ensure that there are a minimum of two staff on the early shift and three on the late shift with one person being awake at night. The area manager told us that the levels had been changed because most people were out at day care or activities during the day and then at home in the afternoons and evenings. We discussed a concern received from a relative about there being less staff at the home and the level of care being decreased. The area manager told us that in the past few months the manager and two senior staff had left at short notice and that this had put a strain on staffing as the home was finding it hard to recruit. Mrs Jenkins told us that this had been resolved by experienced staff being seconded in from other homes in the company. Two experienced staff members have also recently been promoted to senior carers. No new staff have been recruited since the last inspection visit but we were able to Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: see the staff files for the people who had been seconded to the home. All contained the required documentation including a current Criminal Bureau Check (CRB) and training records. At the last inspection visit there were concerns that staff did not have the relevant training and support they needed to safely care for people with complex needs. At this visit we saw that recent training has included Active Support (a structured system for supporting people in a positive and monitored way) and working with people with unique communication methods. The staff team have received other training from the Positive Behaviour Team and have been updated on mandatory training such as health and safety, food hygiene and further training in medication management. From looking at records we saw that the staff team receive regular supervision, staff meetings are held that are also used as training sessions and the staff on duty told us that they were well supported. During the visit we saw that the staff on duty had a good rapport with the people they are supporting and the atmosphere was friendly and supportive. Staff also showed in conversation that they have a good knowledge of the care plans and peoples individual needs. Comments from a parent about staff, seen in the homes quality assurance surveys included, please be assured that we feel that Park Lodge offers a safe, caring and pleasant home and we are very appreciative of the hard working staff. Care Homes for Adults (18-65 years) Page 20 of 26 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. In order to ensure that the improvements made in the quality of care being provided in the home are embedded in practice and consistently supported, a registered manager must be employed as soon as possible. Records are currently in good order and there are systems in place to monitor the quality of the service being provided. Evidence: The home has been without a registered manager since 2008, the previous manager having worked in the home for over a year and had not registered with the Commission. We were told that interviews are to be held for a new manager on 8th December 2009. The home is currently being overseen by an area manager, Mrs Jenkins who told us that she is working in the home for thirty seven hours a week. From looking at records and talking to the staff team during the visit we saw that the area manager has worked at putting structured systems and clear recording in place to guide the staff team and administration support has been seconded to the home in order to update care plans, risk assessments and other records. Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: We discussed with the area manager how the improvements and changes made to the care being provided must be embedded in practice and evidenced over time and the area manager told us that she was aware that a skilled and experienced manager was needed in order to manage the home as people have such complex needs. There is a quality assurance system in place by surveys being sent to families, service users and other people involved with the home and regular internal audits and providers visit are carried out and recorded. We saw that surveys recently received from families were positive and acknowledge the changes to the home. One survey commented, it is a good and happy house with a relaxed and safe environment. We saw evidence in parents meetings notes that families are involved and kept up to date with any changes in the home and regular staff meetings are also recorded. At the last visit a Requirement was made regarding the management of service users monies as these were in a confusing state and could not be easily tracked. At this visit we found that a new system had been put in place, there were clear records and numbered receipts kept on file and the two peoples that we checked were correct. The area manager told us that she had been working with parents to assist people to have their own accounts and some people have already achieved this. From looking at maintenance records we saw that the home is well maintained and during the visit the maintenance person was carrying out monthly checks and decorating. The staff have received updated health and safety and fire training, infection control issues are addressed and there are gloves, aprons and antiseptic hand gels situated around the home. Accidents and incidents are recorded and monitored and Regulation 37 (any serious incident occurring in the home), are being reported to the Commission as required. Care Homes for Adults (18-65 years) Page 22 of 26 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 23 of 26 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 33 18 The registered provider must ensure that there is a permanent staff team in place. This is in order to ensure that service user are receiving a consistent service from a staff team who have the skills and knowledge to support them. 01/02/2010 2 37 8 The registered provider 01/02/2010 must ensure that a manager for the home is recruited and registered with the Commission. This is to ensure that there is a consistent, safe and well managed process of running the home in order to meet service users identified needs. Care Homes for Adults (18-65 years) Page 24 of 26 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 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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