Care Home: Queens Road, 14

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What the care home does well Systems are in place for prospective residents to be assessed prior to admission to ensure the home is able to meet their needs. The service user plans are well completed with evidence that the residents and their representatives are involved in the formulation and review of the care plan. Information on advocacy services is available and residents are encouraged to make decisions and choices within their capabilities. Residents personal monies are well managed. Systems for risk management are in place. Residents have access to various activities within the local community. Residents are supported to maintain contact with their family and representatives. Staff care for residents in a gentle and professional manner, respecting their privacy and dignity. The food provision is good and offers variety and choice to meet residents personal preferences. Residents have access to all healthcare professionals. Systems are in place for the management of complaints and safeguarding adult issues, and these processes are followed effectively. The home is being appropriately staffed to meet the needs of the residents. Staff receive induction training and training in topics relevant to the needs of the residents. Robust recruitment procedures are in place and are followed. The Manager has the skills and experience to manage the home and home is being effectively managed. Overall health & safety is being well managed at the home. What has improved since the last inspection? Service user plans viewed included the changing needs of the residents. The laundry area is now being well maintained. Some improvements have been noted in the area of quality assurance. This area needs to be further developed to ensure that all aspects of care provision are covered. Risk management systems are in place with ongoing review. What the care home could do better: Some shortfalls in medication management were noted, to include poor recording and auditing. The communal areas of the home appear to be shabby and are in need of redecoration and refurbishment as a priority. This includes the shortfalls identified in the kitchen. Whilst improvements have been noted in the quality assurance system in the home further development of the system is required. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Queens Road, 14 Queens Road, 14 Cowley Uxbridge Middlesex UB8 2NN     The quality rating for this care home is:   two star good 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: Rekha Bhardwa     Date: 0 4 1 2 2 0 0 8 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.csci.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: Queens Road, 14 Queens Road, 14 Cowley Uxbridge Middlesex UB8 2NN 01895254925 01895238816 hm14queens@ealing.org.uk 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) : Support for Living care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The Registered Person may provide the following categories 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 - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home 14 Queens Road is a large detached two storey house situated in a quiet residential road in Cowley which is close to Uxbridge town centre. There are local shops and access to public transport close by. There is a front driveway with parking for several cars and a spacious enclosed garden at the rear, which is attractively laid to lawn with patio seating. The ground floor has a large communal lounge/dining room with doors leading to the garden. There is one bedroom on the ground floor, which has ensuite facilities. The kitchen, laundry, offices and cloakroom are also on the ground floor. There are four bedrooms on the first floor and two of these have en suite facilities. There is a further bedroom for staff to sleep-over and there is also an assisted Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home bathroom and a further toilet on the first floor. The home is registered to care for five adults with learning disabilities. Residents fees are based on assessed needs. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection carried out as part of the regulatory process. A total of 8 hours was spent on the inspection process. We carried out a tour of the home, and service user plans, medication management & records, staff rosters, staff records, financial & administration records and maintenance & servicing records were viewed. We met all five residents during the inspection and spoke with three members of staff as part of the inspection process. The Annual Quality Assurance Assessment (AQAA) was also completed and has also been used to inform this report. A number of CSCI surveys for residents, staff, healthcare professionals had been given to the home, however none have been returned and we have not been able to include any comments. Care Homes for Adults (18-65 years) Page 6 of 27 Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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. Systems are in place for the residents needs to be assessed prior to admission to ensure that the home can meet their needs. Evidence: We were informed that no new residents have been admitted to the home for several years. The Manager stated that referrals would be received from the Community Team for Physical Learning Disabilities along with a completed Needs Led Assessment. If the home is suitable the potential resident would be encouraged to visit the home, meet staff and other residents. Day visits and weekend visits would be planned. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear care planning system in place, which provides the staff with the information they need to meet the needs of the residents. Residents are supported to make informed choices about their lives, thus enhancing their quality of life. The home has good risk management systems in place, which promotes the safety of the residents. Evidence: Two care plans were viewed at this inspection. These were comprehensive and detailed the care required by the residents. The care plans covered service users physical, mental, emotional, social, cultural and spiritual needs. Details on how the residents behavior is managed was detailed in the care plans viewed. Daily recordings are completed on each shift. We were informed that the home is in the process of Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: introducing person centred planning. Individual risk management plans are also in place for individual residents. Input where possible had been obtained by the residents representative. We noted that residents had been involved in the formulation and review of their care plan through their personal goals and choices. None of the residents are able to go out unaccompanied. Any limitations imposed on the resident are discussed with the resident, their representative and other health care professionals. Details of any limitations are then recorded in the care plan. Residents are encouraged by the staff to make decisions within their capabilities. Residents are encouraged to make decisions regarding the activities they participate in, food choices, how they wish to spend their time and family involvement. The staff at the home had a good awareness of enabling residents to make informed choices about their lives. Each resident has an individual risk assessment and risk management plan in place. These were available in the residents files. The Manager has in place appropriate systems for risk taking and managing risk. None of the residents are able to go out of the house unescorted. Any activities outside of the home are also risk assessed. Various risk management strategies were in place to deal with residents behaviour and physical health issues. Opportunities for individual development of the residents are assessed and addressed via the care plan. At the time of the inspection none of the residents were able to manage their personal finances. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents participate in a range of activities that meet their individual needs. The home promotes individuality, positive relationships between residents and their families and supports residents to have a lifestyle that suits there individual needs and preferences. Evidence: Residents have access to a range of day opportunities appropriate to their needs. The residents are able to participate in local activities, such as visiting the shops, local pubs, parks, cafes, cinemas, Leisure Centre, library and Uxbridge High Street. Some of the residents also attend a local resource centre daily. We were also informed that all the residents have access to public transport. The home also has its own car. On the second day of the inspection one resident was going swimming. All residents in the home have had a five day holiday within the last year. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Adhoc and planned activities take place. The staff undertake one to one activities. Activities undertaken in the home include some participation in meal preparation and assisting with household chores. The Manager has identified in the AQAA that improvements are required in the choices of activities offered and more day trips for residents. Residents can see visitors in their own bedrooms or in the communal areas. Residents can also visit family and friends outside of the home and have weekend breaks with their family members. All information in relation to maintaining family links is clearly documented in the care plan. There was evidence in the two resident files viewed that staff were supporting the two residents to maintain family contact. The majority of visits to or from the family are pre-arranged and appropriate staffing arrangements are made. The residents daily routines are clearly detailed in their care plans. On the first day of the inspection two residents were at a day centre. Interaction observed between staff and residents was positive and professional. All residents have their own bank account into which their personal allowances are paid. The residents are not allowed to access the laundry without being accompanied by a member of staff. This is due to reasons of safety. We were informed that all residents are involved in developing the menu for the week. The focus is on healthy eating. Menu boards are in place with pictures to aid communication. Dietician input has been accessed for two residents and their advice is being followed. Residents likes and dislikes are clearly recorded in the care plan. The kitchen was viewed and found to be clean and well ordered. Records of fridge/freezer temperature readings were being maintained. All staff working at the home have been trained in food hygiene. There was evidence of regular weight monitoring and eating and drinking assessments being undertaken on all residents. A record of the food partaken by residents is maintained. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support is offered in such a way as to promote residents privacy, dignity and independence. Overall the health care needs of residents are well met with evidence of good multi disciplinary working. The systems for the management of medication were in place however shortfalls found could potentially place residents at risk. Evidence: Assistance and support with personal care is detailed on the service users care plan. This includes their likes and dislikes and gender preference of the carer. Bathroom aids and adaptations are available in the bathrooms. The home has a keyworker system in place to ensure consistency and continuity of personal support to residents. Keyworkers work with the residents in managing their health care needs. There was clear evidence of staff support for residents who become unwell. Records viewed evidenced that any visits to the hospital or GP are clearly recorded. Residents have access to all primary care healthcare professionals. Residents are also reassessed Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: to ensure that the home is able to meet their needs. At the time of the inspection the majority of residents were fully mobile. There is a bedroom with en-suite facilities on the ground floor and one resident with a physical disability can be accommodated. The home uses the Boots Monitored Dosage system. All staff who administer medication have undertaken medication training. On the first day of the inspection no list of staff staff signatures was in place. This was in place by the second day of the inspection. The Medication Administration Records (MAR) were viewed. Several gaps were noted on the MAR sheets and in some cases no explanation or coding had been used to explain the gap. In some instances no dates had been recorded for medications received into the home. Ear drops had the dates of opening recorded. On the second day of inspection we were informed that the gaps noted on the first day had been investigated and that shortfalls had been identified in the administration process. All staff were to be retrained in medication management. Records are kept of all medications returned to the pharmacist. No residents were able to self medicate at the time of the inspection. 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. The systems for managing complaints and adult protection matters are robust, thus safeguarding residents. Evidence: The home has a clear complaints procedure in place. A simplified pictorial version of the procedure has been given to all the residents. One complaint had been received by the home since the last inspection and this was being investigated. The number of complaints are also monitored through the Regulation 26 visits. Staff spoken with at the inspection confirmed that they had received training in safeguarding adults and whistleblowing. The home follows Hillingdons safeguarding procedures. No safeguarding referrals have been made since the last inspection. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment in some areas of the home is poor and does not provide a safe and homely environment to live in. Procedures are in place for infection control, thus minimising the risk of infection. Evidence: We carried out a tour of the premises and the garden during the course of the inspection. Each resident has a single bedroom with three of the bedrooms being ensuite. The rooms viewed were well decorated and had been personalised to meet the residents choices and preferences. The communal areas of the home, corridors and kitchen were shabby and poorly maintained. Paintwork had been damaged and there was evidence of wear and tear. In the kitchen the window was cracked. The lino flooring was raised and a potential hazard. The carpets in the lounge/dining room and the upstairs landing were badly stained and in need of replacement. The home is owned by Notting Hill Housing Group. It appeared that there was little or no investment in maintaining the communal areas of the home to a good standard. The AQAA stated that an internal survey of the property had been carried out by the landlord. There was no evidence that there was a planned maintenance and renewal programme for the fabric and decoration of the premises. Minor maintenance issues Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: are addressed by the Housing Association. The home is close to Uxbridge High Street and has access to public transport facilities. There is a large garden at the rear of the property which can be accessed through the lounge or the kitchen area. There is a small annex building which houses the laundry facilities. This was viewed and was clean and tidy. The home does not employ domestic staff and all cleaning is carried out by the care staff on duty. The home was clean and odour free on the days of inspection. We were informed that staff had received training in health and safety and that this incorporated infection control. Gloves were available. Care Homes for Adults (18-65 years) Page 19 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 home is appropriately staffed to meet the assessed needs of the residents. Overall staff training in the home provides staff with the skills and knowledge to meet residents needs. Systems are in place for the recruitment of staff, thus safeguarding residents. Evidence: At the time of the inspection the home was appropriately staffed to meet the needs of the residents. We were informed that recruitment was in progress to fill the current vacancies. Agency staff are used to cover shifts that are unable to be covered by permanent staff. There are a minimum of two staff on duty and a sleep-in member of staff. The home does not have waking night staff. Where possible staff that have previous experience of working with people with learning difficulties are recruited. Plans are in place to have more resident involvement in this process. The need to ensure that the staffing levels are kept under review in line with the residents dependency levels was discussed with the Manager at the inspection. Only two members of staff have completed their NVQ level 2. We were informed that four members of staff are working towards NVQ level 2 and above. Induction and Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: foundation training to meet the Skills for Care requirements is in place. The pre- inspection Annual Quality Assurance Assessment completed by the Manager detailed the training that had been undertaken and training that had been planned. This included safeguarding adults, moving and handling, first aid, health and safety and food hygiene. Training in the Mental Capacity Act has been planned for all staff. We were informed that all the staff employment records are held at the human resources department at the head office of the organistaion. The home keeps a check list of the information held at the head office for each member of staff. Where agency staff are used the home is sent a profile of the individual prior to placement to ensure that they have the skills and knowledge to work with the residents living at the home. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Manager has the required qualifications and experience to manage the home. She has a clear understanding of the principles of care and support, encouraging residents to remain independent and have choices in all aspects of their daily lives. Systems for quality assurance are being developed and need to be developed further, to provide an ongoing process of review and feedback. Systems for the management of health and safety throughout the home are in place, thus protecting residents, staff and visitors. Evidence: The Manager has been the Manager of the home for two years. She has been the Manager in another care home and has several years experience of working with people with learning disabilities. She is currently undertaking her Registered Managers Award and is due to complete this in February 2009. There was evidence that the Manager undertakes regular training and development to maintain her skills and knowledge. We were informed that some improvements have been made to the quality assurance Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: system in the home. The Manager reported that Support for Living are in the process of putting together a quality assurance system which is based on self assessment. The home does have a quality assurance form which it completes but this required further development to ensure that effective systems are in place for the auditing and review of all areas of care provision. We were informed that resident and relatives satisfaction surveys were completed in July 2008 however there had been a poor return. A comprehensive monthly assessment is carried out for the London Borough of Hillingdon, which covers several aspects of the home. Regular contract monitoring visits take place from Hillingdon Social Services. Regulation 26 visits are carried out and reports of these visits are kept at the home. Staff meetings also take place. Due to communication difficulties formal residents meetings are not held. Information is obtained on a daily basis as to residents satisfaction with the services provided. The home is in the process of developing and implementing picture/resident friendly policies. Staff had received training in health & safety topics to include fire safety, moving & handling, food hygiene and First Aid. Generic risk assessments were in place however these needed to be reviewed as the last review date recorded was 31/7/07. The Manager stated that she was aware of this and that these would be reviewed. Individual risk assessments were in place for residents and identified risks. Servicing & maintenance records were sampled and those viewed were up to date. The fire risk assessment had been updated in February 2008. Fire drills were taking place at the required intervals. Fire safety records viewed were up to date. Overall health & safety is being well managed at the home. Care Homes for Adults (18-65 years) Page 23 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 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Medicines must be recorded accurately when administered. If not administered the correct endorsement must be used. To ensure the safety of the resident. 19/03/2009 2 20 13 All receipts of medications 19/03/2009 received into the home must have their date clearly recorded. To ensure that there is a clear audit trail of medication. 3 24 23 A full environmental audit of 19/03/2009 the home must be undertaken. The Registered Providers must provide an action plan giving details of the areas of the home which require upgrading and the timescales that are planned for the work. Care Homes for Adults (18-65 years) Page 25 of 27 To ensure that the residents live a safe and well maintained environment. 4 39 24 The quality assurance systems in the home must be further developed to incorporate all aspects of care provision. To ensure that systems are in place for review and feedback. 19/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 42 Generic risk assessments should be reviewed annually. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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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