Care Home: Pinetrees

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What the care home does well People told us that they like living at Pinetrees. People told us they clean their own room, help with cooking and help with household tasks. This means people are supported to be independent. People told us they go out and do activities that they enjoy. This means they live fulfilled lifestyles. People are supported by staff who are enthusiastic about their work and understand how to assist people to meet their needs. Health and safety is well managed to ensure peoples safety. People are supported to eat a healthy diet promoting their health and well being. People get excellent support to stay in contact with family and friends so they maintain personal relationships that are important to them. What has improved since the last inspection? Some improvements have been made to staffing levels so people can go out more and do the things they enjoy. What the care home could do better: The owner of the home should visit every month speak to people living in the home and make sure it is being well run. A bigger staff team would allow people to do more of the things that they like to do. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Pinetrees 36 Kensington Road Selly Park Birmingham B29 7LW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Donna Ahern     Date: 0 3 0 9 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Pinetrees 36 Kensington Road Selly Park Birmingham B29 7LW 01214714399 01214724639 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: autism. west midlands care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home Only (Code 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) 4 Date of last inspection Brief description of the care home Pinetrees was previously registered jointly with another of autism.west midlands homes but separated into a single registration in 2005. The home offers accommodation to 4 people with autism spectrum disorder. The home is situated in a pleasant tree lined road; it has modern internal features and a large rear garden. All bedrooms are single rooms. There is sufficient off road parking for three vehicles. The home is not equipped to provide services for people with physical disabilities. Current fees for living at the home range from one thousand and forty pounds per week as Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 4 Brief description of the care home recorded in the statement of purpose for the home. Visitors to the home can see a copy of CQC reports, these are located in the entrance hall. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The Home did not know we, the Commission were going to visit. Four people were living at the home at the time of our visit and we met with all of them. We case tracked two peoples care. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. Time was spent observing care practices, interactions and support from staff. We met with the manager and two staff. We looked around some parts of the Home to make sure it was warm, clean and comfortable. We looked at a sample of care, staff and health and safety records. We were sent an Annual Quality Assurance Assessment (AQAA) by the home. This tells us about what the home think they are doing well and where they need to improve. It also gives us some numerical information about staff and people living at the home. We also looked at notifications received from the home. These are reports about things Care Homes for Adults (18-65 years) Page 6 of 27 that have happened in the home that the Home must tell us about. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need so they can make a choice about whether or not they want to live there. Before people move into the Home their needs would be assessed to ensure they can be met. Evidence: The service user guide and statement of purpose tell people what they can expect from the home. They had been written in a style that is easier for the people living there to understand and included pictures and photographs. The annual quality assurance assessment completed told us that People had their own copies of the service user guide. No new people have moved into the Home for several years. We looked at the policy for pre-admission and saw that very detailed procedures are in place and these include detailed assessments and visits to the Home before any placements are agreed. If these procedures are followed they should ensure that only people who needs could be met by the Home would be admitted. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People make decisions about their lives with support from staff. People have detailed care plans in place so staff can support them in a way that meets their individual needs. Evidence: We looked at the care provided to two people. We asked people if we could look at their care plans. Care plans explain what each person needs are and the care and support they require from staff to make sure these needs are met. The files looked at had lots of information about how to meet peoples individual needs in relation to personal care, communication, health care, social activities, likes and dislikes. Care plans seen were very individual and included peoples cultural and religious needs so people continue to get the support they need to meet these needs. We saw that people are involved in care planning by completing their own person centered plan. This details their likes, dislikes and preferences so they continue to receive support in a way that meets their individual needs. The manager asked one of the people if she could share some information with us about their care. The person joined us and they Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: were involved in telling us about the support they receive from staff to meet their needs. We saw that alterations are made to peoples care plans when there has been a change in need. Staff told us that changes are discussed in staff meetings and at hand overs so people continue to get the support they need. Weekly meetings take place with people. The AQAA told us All service users are encouraged to put items on the forthcoming agenda and they take turns to chair the meeting. We saw the minutes of the meetings and these confirmed they are used to discuss issues which affect their lives at Pinetrees. We spoke to two staff who had good knowledge about peoples individual needs. They read peoples care plans. They spoke very positively about the quality of life that people experience at Pinetrees. Behaviour management plans are in place for each person. These tell staff about warning signs and triggers and tell staff how they should support people in a way that promotes peoples dignity, managed consistently and promotes peoples well being and safety. Detailed communication passports are in place. These detail the very specific communication needs of the individual and were very current with new information being added as it arises. The passports are essential for staff to read and understand so staff support and interact with people in a way that meets their individual needs . We saw a number of risk assessments had been completed. These should detail what action staff need to take to ensure risks to people are kept to a minimum. The manager was in the process of rewriting and updating these so information is up to date and written in a way that is easy to follow. We saw throughout our visit that the interactions between people and staff were very positive. Staff supported people in what they wanted to do and helped people make decisions about their daily life. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People experience a meaningful and individual lifestyle so they do the things they like and enjoy. People eat a healthy diet so maintaining their well being. Evidence: We looked at care plans and daily records to establish that people are leading meaningful lifestyles and taking part in activities that they enjoy. We also spoke to two staff members and observed care and support on the day. People are asked in the weekly peoples meeting about their request for activities. These are then worked around appointments and fixed activities. One of the people does some paid administration work for the organisation a few days each month. Another person attends a work placement one day each week. People are supported to take part in a range of hobbies and personal interest including attending language classes and a drama group. One of the people enjoys horse racing and has been Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: supported to attend a number of race meetings across the Midlands. One of the people has an interest in the Olympics and athletic events. They have been supported to take part in a range of events to pursue their interest including attending athletic events, join the athletic association web site and go to London to track the olympian route. We saw that people are supported on a very individual level to live ordinary and meaningful lifestyle. We saw people being actively involved in all areas of daily living. We saw people help prepare meals, do their clothes washing and help with work in the front garden. Staff gave support in a enabling and non confrontational way. It was very much peoples own home with staff there to guide and support as and when needed. People told us when they are at home they like to watch films, listen to music and use the computer. People have the opportunity to go on holiday if the want to. We were told that people now chose to go on holiday on their own as oppose to going with their peers,this is staffed with two staff so people get the support they need. Two people were supported to attend a music summer school in Shropshire both people stayed for a different duration of time according to what they wanted to do. People are supported to maintain links with family and friends. They are supported to telephone and write letters. Some people visit their family and staff support them to do this. People are involved in planning the menu. They take it in turns on a weekly basis. The AQAA told us This system works well giving choice and variety to the meals offered and reflects each persons favorite foods and preferences are observed within a healthy eating structure . We joined people for lunch. Staff sat and eat with one of the people. One person chose to eat their in the lounge and another person chose to eat later. People had a choice of different foods including salads, sandwiches and home made soup. Food served was freshly prepared, nutritious and well presented. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the support they need to ensure their health care needs are met. Evidence: Care plans included information about how people wanted to be supported with their personal and health care needs. Records seen indicate that people are encouraged to maintain their independence and support from staff promotes this. Currently all the people who live at Pinetrees are male. Within the staff team there is a good balance of female and male staff. Each person has a designated key worker which should ensure consistency and continuity of support. Peoples clothing, hair and personal care were well presented. We looked at health care records for two people. Records showed that people have regular health checks with the dentist ,optician and podiatry. People are also supported to attend hospital appointments and complimentary health care appointments such as chiropractor. People are supported to record the outcome of their own appointments in their own health action plans. These documents are Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: presented in a picture and photograph format so it is in an easy to understand format. This ensures that people are fully supported to take control and manage their own health care. We saw that there is no prescribed medication in use. It is really positive that staff manage peoples behaviour by their approach rather than medication. Medication procedures, secure storage systems and staff training are in place so if medication was to be prescribed the policies and procedures should ensure it is administered safely. Care Homes for Adults (18-65 years) Page 16 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. People are listened to and arrangements in place ensure people are protected from the risk of harm. Evidence: We saw the complaint procedure which is written in an easy read format so it is easy for people to follow and understand. The manager was in the process of up dating our contact details so people know how to contact us if they need to. People who live at the Home who returned our survey told us they knew how to make a complaint. Staff who we spoke to told us they knew what to do if someone had a concern about the Home. We had not received any concerns or complaints about this Home. One complaint had been received by the Home and this had been dealt with. We saw policies and procedures for safeguarding people and these are available for staff to read. The manager told us about an incident that had happened in the Home which was passed onto Social Services as a safeguarding matter and was still being looked into. Staff receive safeguarding training every year and the manager was just planning another up date so staff remain up to date in their knowledge and should know how to deal with concerns if they arise. We looked at two peoples financial records. Some people have their own bank account. We saw that records had been signed by people and a record sheet is kept detailing what has been spent and receipts are kept. Staff check amounts and Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: balances at the afternoon hand over which ensures that financial safeguards are in place. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, comfortable, safe and clean environment that meets their needs. Evidence: The Home has two lounges for people to use. One of the lounges has a television, lots of comfortable seating and a range of peoples videos that they told us they like to watch. The second lounge has a computer and work area for people, a fish tank and seating areas. We saw during the day when people are at home they enjoy spending some time in the communal areas but also like to spend time in their own bedrooms. Two people showed us their bedrooms. We saw that these contained many personal possessions that we could see are important to people. Since our last visit a new cooker has been purchased and lever taps have been fitted throughout the house and the wastes have been replaced on wash hand basins. A new telephone system has been installed which provides two in coming lines so people have better access to the telephone. One of the people showed us where they do their laundry which is in a small utility area off the main kitchen. The kitchen is spacious with lots of storage and there is a large dining table where people can eat their meals if the chose to. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: The home has one ground floor bedroom and a ground floor shower and toilet so facilities are accessible to people. The Home was clean and fresh and good arrangements were in place for infection control so any risks to peoples wellbeing is minimised. To the rear of the house there is a lovely spacious well kept garden for people to relax in and enjoy. The office is located in a conservatory off the rear lounge. The door is insecure and comes open. This makes it difficult to have confidential discussions and meetings in the office. This may also disturb people using the rear lounge to relax in or to do their hobbies. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements in place for staffing the home generally ensure that the needs of the people living there are met. Evidence: We saw that support to people who live in the Home is given in a polite, calm and consistent manner. Staff took the time needed to listen to and responded positively to requests that people made. We saw staff encourage , promote and reassure people. When we spoke to staff they were able to tell us detailed information about meeting peoples needs. The annual quality assurance assessment told us that three of the six staff have achieved a National Vocational Qualification in care and two staff are completing it. This means that people are supported by well qualified staff. People living in the Home who completed a survey told us I do like the staff they treat me well and They treat us alright . We looked at the staffing rota and saw that staffing levels have been increased since our last visit. This allows staff to do more 1 :1 work with people. Although staffing levels have been increased at weekends and evening there are still occasions when there is only one staff on duty. Staff told us that activities have to be planned in advance so staffing levels can be adjusted to meet peoples needs. The staffing team is Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: very small with six permanent staff which allows limited flexibility and present difficulties when covering staff sickness, leave and training whilst trying to provide a consistent service to people. Although there has been some staff turn over this year it was positive to hear that no agency staff have been used. This ensures consistency for the people living there. Four of the five staff who completed a survey told us that a bigger staff team was needed so they could do their job well and be more flexible when supporting people. We spoke to the staff about the training they have received and looked at the training records. The manager was in the process of updating the records so it was easy to follow what training had been done and when. The organisation provides very specific training around the needs of people with autism spectrum disorder . This ensures that staff have the specialist training they need to do their job. One of the professionals who completed our survey told us The care and consideration given to X is exceptional by all staff at Pine Trees, X often talks of the house and is very happy there. Five Staff told us in the surveys completed that they get the support to do their job. Staff told us their induction covered what they they needed so they could do their role. We saw that the staff supervision takes place every few months so staff get the support to do their job. Staff told us that there is a handover every day so they get the information they need to support people consistently. We looked at the recruitment records. Checks undertaken include criminal record bureau checks and written references before staff started working in the Home so people are protected from the risk of having unsuitable staff working with them. 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. People live in a well managed home. Arrangements ensure their health and welfare is promoted and protected so ensuring their well being. Evidence: The manager is registered with us. She has worked at the Home for several years and has a significant amount of experience in care. She has completed the Registered Managers Award as well as having an NVQ 4 care qualification. She has also kept up to date with current legislation and attends training to update her knowledge, skills and competence. The manager completed the annual quality assurance assessment when we asked for it . It was completed to a good standard and told us what the home does well and where it could improve. The Home is very well managed. The manager is open and inclusive in her style of management. The Home very much feels like it is peoples own home the aims and objectives of this service are well and clearly promoted. The manager welcomed any Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: recommendations for improving standards in the Home for the benefit of the people living there. We raised some concern at the last visit about the amount of time the manager works on shift or in her own time to ensure that management tasks are completed. We asked that management arrangements were looked at and improved. We found that very little improvement had been made to change this. It is the responsibility of the organisation to ensure that their representative should visit the Home monthly to monitor the Home and report on standards. This is when matters of concern should be picked up and dealt with. We saw evidence that visits had taken place infrequently which indicates that the visits are not being done as required. The views of the people living there are sought through regular peoples meetings,key worker meetings, surveys and person centered planning reviews. The Home works closely with peoples families and funding authoritys. We were told in the annual quality assurance assessment that the organisation has been awarded the Investors In People award. People have access to their records and are supported to maintain their personal records. Records about peoples care are very well maintained. Staff record what care has been given and how people have responded to care and support. Health and safety audits take place and people living in the Home help out with some of these. They help do the vehicle check including tyre pressure, lights and water and oil levels on a weekly basis. People also help with the weekly fire alarm check and the call points are checked in rotation. Water temperature testing, emergency lighting checks take place on a monthly basis so people are protected from any risks to their safety. The annual quality assurance assessment told us that Gas and fire system tests are up to date. We saw that a work place fire risk assessment detailing the providers responsibility to protect people from the risk of fire was in place and up to date. 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 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 3 9 33 33 Risk assessments should be up dated so people continue to get the support they need to be safe. Staffing levels should continue to be monitored so that there is enough staff available to meet peoples needs. The staffing assignment for the home should be looked at to ensure there is enough staff employed so the Home can run smoothly and meet peoples needs. Staff training records should be up to date so it is clear what training has been completed and what is due for up dating. This will ensure that staff continue to have the knowledge they need to meet peoples needs. The arrangements in place for the management of the home should be reviewed and should ensure that sufficient time is available for the manager to do the job. The home should be visited monthly by the representative of the provider and a report made of the visit to ensure the provider is overseeing that the home is well run. 4 35 5 37 6 39 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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