Care Home: Raglan House

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What the care home does well The home is welcoming, relaxed, clean, and tidy.People and staff get on well with each other.People who live at the home are given support to enjoy their leisure time and do things in the community.Staff have been trained in how to care for people.There are good care plans for people. So that staff know what support and care people need.Not many staff leave so the same staff keep supporting people.Staff know what help people need. People feel safe with staff.There is good health and safety in the home. What has improved since the last inspection? Staff have received more training. This means that they know how to support people, as they get older.Hand rails have been put up to make it easier for people to walk around the house and garden.Information and care plans have pictures to make it easier to understand. What the care home could do better: The manager needs to look at any risks from new staff and do checks with their last care job. This is so new staff are safe to work at the home.Staff should help people start `life story` books. This is so people can see photos and things that show what they have been doing.Peoples` care plans and files need to have the right information about them to help staff give the right care and support. Key inspection report Care homes for adults (18-65 years) Name: Address: Raglan House 3 Carlton Road South Weymouth Dorset DT4 7PL The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jo Johnson Date: 1 4 0 9 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 35 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 35 Information about the care home Name of care home: Address: Raglan House 3 Carlton Road South Weymouth Dorset DT4 7PL 01305784192 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) : raglanhouse@hotmail.com Mr Patrick James Matthews,Mrs Caroline Elizabeth Kelly care home 7 Number of places (if applicable): Under 65 Over 65 7 0 learning disability Additional conditions: As at present, one named person (as known to CSCI) to be accommodated in the category of mental disorder. Four named people (as known to CSCI) to be accommodated in the category of LD(E) and three people in the category of LD (18-65). Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home The house has seven bedrooms, two bedrooms are downstairs and one bedroom is for staff to sleep in. Seven people live at the home. 5 Two people choose to share one bedroom, everyone else has their own bedroom. The home is close to Weymouth town. There is a local bus service and a large car that people use. Care Homes for Adults (18-65 years) Page 5 of 35 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 Care Homes for Adults (18-65 years) Page 6 of 35 How we did our inspection: This is what the inspector did when they were at the care home The inspection was unannounced (we did not let the home know we were coming) on 10th September between 9.45 am to 2 pm and 14th September at 3.45 pm to 6.30pm. The inspector looked around the house with someone who lives there. Care Homes for Adults (18-65 years) Page 7 of 35 The inspector talked and completed surveys with people who live at the home. The inspector looked at care plans. The inspector looked at some of the paperwork about the home and the staff. The inspector talked to the staff and the manager. Care Homes for Adults (18-65 years) Page 8 of 35 What the care home does well The home is welcoming, relaxed, clean, and tidy. People and staff get on well with each other. Care Homes for Adults (18-65 years) Page 9 of 35 People who live at the home are given support to enjoy their leisure time and do things in the community. Staff have been trained in how to care for people. There are good care plans for people. So that staff know what support and care people need. Care Homes for Adults (18-65 years) Page 10 of 35 Not many staff leave so the same staff keep supporting people. Staff know what help people need. People feel safe with staff. There is good health and safety in the home. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 11 of 35 Staff have received more training. This means that they know how to support people, as they get older. Hand rails have been put up to make it easier for people to walk around the house and garden. Information and care plans have pictures to make it easier to understand. Care Homes for Adults (18-65 years) Page 12 of 35 What the care home could do better The manager needs to look at any risks from new staff and do checks with their last care job. This is so new staff are safe to work at the home. Staff should help people start life story books. This is so people can see photos and things that show what they have been doing. Care Homes for Adults (18-65 years) Page 13 of 35 Peoples care plans and files need to have the right information about them to help staff give the right care and support. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jo Johnson Telephone: 03000 616161 Care Homes for Adults (18-65 years) Page 14 of 35 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 15 of 35 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 16 of 35 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. Peoples needs are assessed and they are provided with information so that they are clear about their rights and entitlements at the home. Evidence: The Statement of Purpose and Service User Guide are in large print and supported by pictures, which makes it easier for people with learning disabilities to understand the services in the home. There have been no new people admitted to the home for three years so the outcomes for any new person coming to live in the home could not be assessed. However, there are ongoing and regularly updated assessments in peoples care records that have been amended as their needs have changed so that staff have up to date information about them. Care Homes for Adults (18-65 years) Page 17 of 35 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. The people living in this home are involved in decisions about their lives and are playing an active role in planning their care and the support they receive. Evidence: Three peoples care records were seen. There is a new care record system in place at the home. The care plans and risk assessments had recently been reviewed and included all the care and support they need. Any changes in need had been quickly identified and planned for. There were good descriptions of how staff are to support individuals to make choices and decisions in their every day life. The people have a copy of their person centred plan in a format that is accessible to each individual. From discussion with the manager and people who live at the home, there is a focus on Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: promoting peoples independence and positive risk taking. Risk assessments were in place for each person that were regularly reviewed as part of the care plan reviews and as new or changed risks were identified. They were clear and easy to follow. One person has epilepsy and there was not any epilepsy management plan in place in the new care plan and recording system. The manager and staff spoken with were clear on how to manage any seizures, what actions to take and at what point to call the paramedics. There were comprehensive records of any seizures and the contact with epilepsy nurse. The manager believed that the epilepsy plan had not been transferred to the new care plan and records. By the second day of inspection the epilepsy plan was in place. People living at the home do not have ongoing life story books and when people where asked if they had photos or anything to show what they had been doing (apart from holidays and day trips) they did not have anything accessible. Life story books have photographs and items in them that show what the person has been doing in their lives. Staff should develop life story books/works with people living at the home who want to, as these give a much more interesting picture of how people have been spending their time and people may find them easier to follow than written records. This means that people can be actively involved in the monthly reviews of their plans and goals. Discussions with people and their surveys show that they make decisions about what they do each day. Care Homes for Adults (18-65 years) Page 19 of 35 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. The people living in this home are supported to make choices about their lifestyle. Daily activities promote independence and opportunity for people to live ordinary and meaningful lives in the community where they are living. Evidence: On arrival at the home all of the people except one were either out in the community or attending community day services. We returned another early evening to spend time with all of the people at the home. People chose where to spend time in the lounge, activities room, garden or in their bedrooms throughout the inspection. All of the peoples surveys shows that they can choose how to spend their time during the week and that they can do what they want at the weekend. One survey included the comment, we go out often to different places and also coffee mornings. Most of the people living at the home attend day community services for at least two Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: days a week. People attend either learning disability, mental health or older people day services. One person said and wrote in their survey I like my job. From information provided in the AQAA the manager told us that The home is involved with the local community attending many local events during the evenings and weekends and making use of the local facilities such as the pubs,social clubs,cinema, library, church fetes, garden fetes etc. Friends and family are welcome into the home at the residents request and can go to a private room if they so wish and are also supported when visiting friends and family. People told us that they have friends to visit and that staff take them out if they want to go anywhere. One person told us that they go out independently and that I have tell staff when I go out and I come back home by nine so they dont worry about me, staff help me. Some of the people recently went on holiday to Butlins. There were photos displayed in the dining room of the holiday. People of age where they do not want to participate in the cooking and or heavy housework. Some of them told us that they take part in dusting and tidying their rooms. One person likes to assist with taking their laundry to the washing machine. The records show that people are provided with a well-balanced and nutritious diet. All food being stored in the kitchen looked fresh and was well within the use by date. We observed people helping themselves to drinks and food throughout the inspection. Staff cook the meals and people help to clear their plates after the meals. People have specialist cutlery where appropriate. People told us that they do not want to cook dinners or go food shopping. One person said I make cakes with XXX (staff). Care Homes for Adults (18-65 years) Page 21 of 35 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. The health and personal care that people in this home receive is based on their individual needs. Staff respect the people and promote their dignity and privacy. Evidence: There were positive relationships and interactions observed between staff and the people who live at the home. The staff and manager encouraged and supported people in a relaxed way. All of the people living in the house said that they like and get on well with the staff. Every one knew who their key worker was. Peoples health records and care plans showed that their right to good-quality physical and mental health care is being promoted. The records show that as part of promoting their health people make regular visits to a dentist, optician, specific health consultants, their GP and a chiropodist when needed. There were clear records that reflected the health changes and difficulties accessing health services for one individual and they showed that the home has been pro active in following up this. They are currently pursuing a best interest assessment under the Mental Capacity ACT and awaiting the appointment of an IMCA for this individual. People who live at the home are encouraged to go for walks and keep fit to maintain their Care Homes for Adults (18-65 years) Page 22 of 35 Evidence: mobility, as they get older. Staff are trained in the medication policies and procedures during induction and there is a medication training programme. Medication records seen were correct and the manager and staff actively monitor the completion of the medication records. A number of people have PRN (as required) medication. Some of the plans for taking as required medication did not specify under what circumstances it is to be given, how long between doses and what is the maximum dose in 24 hours. PRN (as required) medication plans must be written. The prescribing practitioner or health professional should approve these medication plans where possible. This is so that staff know how and when to safely administer as required medication. This had been actioned by the second day of the inspection and further easy to follow information was available for all of the medication that everyone at the home takes. To date there have not to date been any controlled drugs in the home and there is a controlled drugs storage facility at the home. The manager and staff continue to be proactive at meeting the specific social, health and personal care needs of the people who are ageing at the home. There are good systems in place for monitoring peoples physical well being. Care Homes for Adults (18-65 years) Page 23 of 35 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 people who live in this home are able to express their concerns and know whom to speak to if they are unhappy or feel unsafe. They are supported by a staff team who have a good knowledge of how to respond to any suspicion of abuse. Evidence: People have access to a complaints policy, which is in picture and large print format and includes information about us. There have been no complaints or allegations of abuse received by the home or commission since the last inspection. The manager told us on the AQAA (Annual Quality Assurance Assessment) that there have been no complaints at the home from the people that live there. The manager has kept a record of any issues or concerns raised by the people who live there. There was only one concern recorded and this had been addressed. The surveys show that people know who to speak to if they are not happy and know how to make a complaint. one person said I would tell xxx (manager) another person said I would talk to staff and they would sort it out. An adult protection procedure is in place at the home so that staff know how and to who they can report any suspicions of abuse. The staff and manager spoken with were confident of how to use these procedures. Care Homes for Adults (18-65 years) Page 24 of 35 Evidence: Systems are in place to safeguard the finances of the residents in the home. People said they felt safe and would know whom to talk to if they were unhappy. Care Homes for Adults (18-65 years) Page 25 of 35 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 is well maintained and furnished so that people live in a clean, comfortable and homely environment to live in. Evidence: There is a warm and welcoming atmosphere in the home and at the time of the visit, it was homely, comfortable and safe. People living there were able to move around easily and freely and to go to their bedrooms if they chose. Since the last inspection, the manager has planned the changes that are needed to the environment as people become increasingly frail. There is now a bathing aid that supports people in and out of the bath, grad rails and additional handles have been put up. The manager has made investigations into whether a stair lift can be fitted if needed. One of the people proudly gave us a tour of the communal areas of the house and their bedroom. The home was clean and free from any offensive odours. The surveys returned shows that the home is always fresh and clean. All of the people living in the home were happy to show us their bedrooms. The bedrooms reflected their individual lifestyles, interests and tastes. Care Homes for Adults (18-65 years) Page 26 of 35 Evidence: One person commented on their survey that they would like a new carpet in the dining room, There are established policies and procedures in place for the control of the risk of infection in the home and staff practices during the visit were seen to be safe. Infection control training is included in mandatory training for all staff. Care Homes for Adults (18-65 years) Page 27 of 35 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 people living in this home are protected by robust recruitment practices and supported by a skilled and competent staff team. Evidence: The home has a very low turnover of staff with only one staff leaving and one going on maternity leave since the last inspection. Staff sickness levels are also very low and this means that a consistent staff team that they know well supports the people living at the home. The manager said that since the last inspection new staff have been recruited to replace the staff that have left or gone on maternity leave. The training chart in the home shows that staff have accessed training in the full range of mandatory, health and safety related training, (e.g. first aid, food hygiene, infection control, medication, adult protection and fire safety) as well as specialist courses, such as dementia, diet and nutrition, epilepsy, death, dying and bereavement, Mental Capacity Act and equality and diversity. Staff spoken with told us that that they are given training that is relevant to their role, helps them understand and meet the individual needs of service users and keeps them up to date with new ways of working. Three staff files including the two most recently recruited staff files were seen. All of the Care Homes for Adults (18-65 years) Page 28 of 35 Evidence: files all included CRB (Criminal Records Bureau) checks and two references. One persons references were not obtained form their last care sector employer. A last care sector reference should be obtained to make sure that there is an accurate up to date and relevant reference for new staff. On person had an adverse CRB check. This was discussed at interview but not declared on their application form. A record of the discussion regarding the declaration should be kept and a risk assessment must be completed. This is to make sure that staff are suitable and safe to work with vulnerable people. Staff spoken with said they had regular two monthly supervision and staff meetings. The staff supervision and meetings minutes were seen. Discussion with staff and examination of the staffing rota shows that there continues to be good levels of staff support for the people living in the home. People living at the home said they know all of the staff and who is working each day. There is a weekly rota on display in the dining room. People and the surveys told us that staff treat them well and they act and listen to what they say. Care Homes for Adults (18-65 years) Page 29 of 35 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 benefit from living in a well run home. They are able to express their views of the service provision and know that their views will be listened to and acted upon. Evidence: The manager has been in post for over ten years and has been the owner for nearly four years. She has achieved the Registered Managers Award and is well qualified for the role as Care Home manager. From discussion with people living at the home, staff, the manager, the examination of records and observation of care practices show that a competent and skilled manager runs the service. The staff and manager are very proactive with identifying areas for improvement with the people who live at the home. People said that they have regular house meetings where they can say what they want about the running of the home. People are involved in the recruitment of staff. The people living at the home are surveyed for their views on an annual basis. The outcomes of this consultation are summarised and fed into the development plan for the Care Homes for Adults (18-65 years) Page 30 of 35 Evidence: home. The manager described the quality assurance system in place, which includes the monthly reviewing of care plans, audits of accidents, falls, medication, peoples finances and health and safety practices. Information provided before the inspection, by the manager in the AQAA (Annual Quality Assurance Assessment) shows that relevant Health and Safety checks and maintenance are being carried out at the home. A number of Health and Safety records were checked, including the fire safety log. These records showed that health and safety matters are well managed. Care Homes for Adults (18-65 years) Page 31 of 35 Are there any outstanding requirements from the last inspection? Yes  No  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 32 of 35 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 Description 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 Description Timescale for action 1 34 13 Risk assessments specific to an individuals roles and responsibilities must be completed for any staff that have criminal convictions. 01/11/2009 This is to make sure that any risks have been assessed and that staff are suitable and safe to work with vulnerable people living at the home. 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 6 Staff should develop life story books/works with people living at the home who want to, as these give a much more interesting picture of how people have been spending their time and people may find them easier to follow than written records. This means that people can be actively involved in the monthly reviews of their plans and goals. Page 33 of 35 Care Homes for Adults (18-65 years) 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 2 3 6 34 Any specific health plans such as epilepsy plans should be kept with the new care plan and recording documentation. A last care sector reference should be obtained to make sure that there is an accurate up to date and relevant reference for new staff. A record of any discussions at interview relating to CRB declarations should be kept. This is to demonstrate what was declared and discussed before the receipt of any adverse CRB check. 4 34 Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: Telephone: 03000 616161 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) 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. 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