Care Home: REACH Vale Road Chesham

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What the care home does well The home ensures that prospective service users to use the service have a preadmission assessment prior to moving into the home. The home ensures that service users` care plans are comprehensive to enable them to experience a satisfying lifestyle. Personal and health care needs are recorded in service users` care plans to ensure that they receive the assistance they require. The home ensures that service users live in a homely, well maintained comfortable and safe environment. The home ensures that the staffing levels are adequate to meet the diverse needs of service users. What has improved since the last inspection? The home`s statement of purpose has been reviewed to ensure that it complies with Schedule 1 of the Care Homes Regulations. The home has reviewed the arrangements for the storage of medicines to ensure that all medicines are stored securely. The home now ensures that personnel files retained in the home include evidence of compliance to the regulations in the recruitment of staff. What the care home could do better: The manager must ensure that she starts the registration process with the Commission to comply with current legislations. There must be clear guidelines in place agreed in a multi-disciplinary forum detailing the reasons why staff need to have access to service users` pin numbers. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: REACH Vale Road Chesham 17 Vale Road Chesham Buckingham HP5 3HH     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: Joan Browne     Date: 1 3 0 2 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 28 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 28 Information about the care home Name of care home: Address: REACH Vale Road Chesham 17 Vale Road Chesham Buckingham HP5 3HH 01753888688 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) : chesham@reach-disabilitycare.co.uk REACH Limited care home 6 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Additional conditions: 6 6 The maximum number of service users who can be accommodated is 6 (six) The registered person may provide the following category of service only: Care Home only (PC) - to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 6 (six) Physical disability (PD) - 2 (two) Date of last inspection Brief description of the care home Vale Road is a detached house which provides residential care to adults with learning disabilities. The home can accommodate six people. It is located in a residential area about one mile from the centre of Chesham. The nearest rail station is Chesham (London Underground Metropolitan Line). There are buses from Chesham to Amersham, Berkhamsted, High Wycombe and other areas. There is limited parking to the front of the house or in the street. The home has its own vehicle (a people carrier) for the people living and working there. There is a pleasant garden on two levels to the rear of the home. The ground floor accommodation and patio area of the garden is wheelchair accessible. Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 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 unannounced site visit which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection (CSCI) was undertaken by Joan Browne on 13 February 2009 and lasted for approximately eight hours. The last key inspection on this service was completed on 18 February 2008. The CSCI Inspecting for Better Lives (IBL) involves an annual quality assurance assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps us to prioritise the order of the inspection process and is referred to in the report. The information contained in this report was gathered mainly from records kept at the service and information contained within the AQAA. We also looked at care plan documentation, staff recruitment files, training records, medication documentation, Care Homes for Adults (18-65 years) Page 6 of 28 health and safety records, discussions with staff and service users and observed staff practice. A tour of the premises was conducted. One requirement and four recommendations of good practice were issued on this visit. Please see outcome areas for individual needs and choices, lifestyle, staffing and conduct and management of the home for full disclosure. Feedback was given to the manager during the inspection. We (The Commission) would like to thank all staff and service users who made the visit so productive and pleasant on the day. 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 28 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 28 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. The needs of prospective service users are assessed before admission to ensure that the home is able to meet their diverse needs. Evidence: At the previous key inspection a requirement was made for the service to review and update the homes statement of purpose to ensure that it complies with Schedule 1. It is pleasing to report that the requirement had been complied with and the document now complies fully with Schedule 1. We noted that the document referred to the manager as the registered manager. As the manager has not yet been registered with the Commission she was advised that the word registered should be deleted from the document until she becomes registered. The document also stated that there were two team leaders in post. We found that the team leaders positions were vacant and had been for sometime. The manager was advised to amend the document to reflect the current vacant positions. A further requirement was made for the service users guide to be reviewed so that it is specific to the service and complies with the regulations. The service users guide was examined and still appears to be written in general terms Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: for all REACH homes. However, the document now includes specific information such as, the room number to be occupied, the license agreement, fire safety, maintenance and redecoration, out of pocket expenses and termination of the license. There is still a sentence in the service users guide relating to the complaints process, which is still not explicit and does not inform the reader that they should be able to contact the Commission at anytime during a complaints investigation. However, we did note that the main complaints procedure reflected this information. The annual quality assurance assessment (AQAA) stated that a detailed pre and post assessment is undertaken by the operations director and the care services manager. In the three care plans examined we found that a pre -admission assessment was undertaken and the individuals were gradually introduced to the service. We noted that one particular service user had visited the service several times before taking up the placement permanently. Care Homes for Adults (18-65 years) Page 11 of 28 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. Service users care plans outline their likes and dislikes including risk assessments, which should ensure that their diverse needs are met and independence is promoted. Evidence: Case tracking identified that individuals care files consisted of the following documentation: the care plan, the information file, the health passport and the personal diary. The information in care plans was clear and detailed how individuals expressed him or herself and how staff should respond. Significant people and things that are important to service users were outlined also their likes and dislikes. We saw evidence, which demonstrated that the plans were reviewed regularly. In the file for one particular service user several reviews had taken place since admission. Risk assessments were seen in the files for the three service users whose care was case tracked relating to bathing, smoking, using the kettle, absconding, preparing meals and arson. Staff were observed working with service users and supporting them to make decisions Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: such as choosing what they wished to eat and participating in daily living activity such as shopping. One particular service user spoken to was confident that staff supported and respected his decisions. There were no service users using the services of an advocate at the time of the inspection. None of the service users were actually managing their finances. However, one particular person had a debit card which was kept in the homes safe for safe keeping. The practice in place was whenever the individual needed to withdraw money staff would escort the individual to the bank and withdraw the money. All staff were aware of the individuals pin number. This arrangement may have been agreed to promote the service users best interests. However, they need to be accurately recorded to reflect the reasons why and agreed in a multi-disciplinary forum with the agreement of the service user or their representative. Care Homes for Adults (18-65 years) Page 13 of 28 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. To ensure that service users lifestyle is promoted they are supported by staff to participate in a range of social activities in the local community based on their interests and abilities. Evidence: The annual quality assurance assessment (AQAA) reflected that some service users were accessing further education at the local college in subject areas of interest to them. We found that one service user was attending college full time and three were attending part-time undertaking pathway type courses in numeracy, literacy, information technology and cookery. One service user was doing a plumbing course and said that he was enjoying it. Staff were supporting the individual to find a work placement in the local area. The manager said that she had approached a local school to enable some service users to use the sensory room and the therapy pool once a Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: week. Arrangements were in the process of being finalised. Staff and service users regularly went shopping at the local supermarket in Chesham. Visits to the local library, leisure centre and park are regularly undertaken. On the day of the visit some service users participated in a shopping trip in the morning and a walk to the local park in the afternoon. The home has its own transport facility but not all staff hold a drivers license. Staff support service users to maintain family links. One particular care plan detailed the agreement in place for the service user to make regular telephone calls to their relative. Family members are encouraged to visit. We were told that the homes Christmas party was very successful and all family members and friends attended and complimented staff for the lovely food they provided. Some service users are expected to keep their bedrooms clean and tidy with support from staff. Those who are able to, look after their own laundry with minimum support from staff to promote independence. Meals are planned with service users. Breakfast consists of cereals, fruit juice, toast with marmalade. Lunch is a light meal as some service users attend college. The main meal is served in the evening. One service user said that he often assists staff with the preparation of the evening meal and was very proud to be able to prepare a lasagne dish, which turned out quite tasty. Lunch was taken with service users and staff. The choice on offer was jacket potatoes with tuna and corn filling and yogurt for dessert. Lunch was a relaxed and unrushed activity. Service users who required assistance were assisted by staff. We observed that staff used the plastic aprons that they use to provide personal care on some service users to protect their clothes. This practice should be reviewed to ensure that individuals dignity is promoted. Care Homes for Adults (18-65 years) Page 15 of 28 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 arrangements in place for meeting service users health and personal care needs are carried out in a sensitive and person centred manner. Evidence: Staff spoken to said that personal care is provided to service users as outlined in their care plan. Individuals choose what clothes they wish to wear and what time they wish to rise and retire. The home has technical aids and equipment such as, wheelchairs and a bath lift to assist service users and to promote independence. Wherever possible the home would seek advice from health experts on how to obtain aids to enhance and promote individuals independence. For example, one person who is registered blind the manager has arranged with an expert from the blind society to carry out a detailed assessment with a view of obtaining the appropriate aids and equipment to enhance the individuals lifestyle All the service users are registered with a general practitioner in the area. The staff team receive support when required from the learning disability team. Evidence seen in the care plan files demonstrated that service users have regular dental and optical checks. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: There were no service users assessed as able to manage their own medication on the day of the inspection. The home uses a monitored dose medication system which is dispensed by a local pharmacist. The medication was stored in an appropriate medication cupboard attached to the wall. There were no unexplained gaps noted on the medication administration record (MAR) sheets examined and there was a clear audit trail for all medicines entering and leaving the home. Staff confirmed that two staff members administer medication and this is deemed as good practice. All staff have to be assessed as competent by the homes manager and undertake a written test before they are allowed to administer medication. The home has a homely and a PRN (give when necessary) medication procedure in place. Homely medicines are administered on the authority from the general practitioner and a copy of the relevant letter is kept in the medication folder and this is deemed as good practice. Care Homes for Adults (18-65 years) Page 17 of 28 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 home has a complaints and safeguarding policy in place to ensure that people are able to express their concerns and are protected from abuse and have their rights protected. Evidence: At the last key inspection a requirement was made for the homes complaints procedure to be explicit and inform complainants that they can refer a complaint to the Commission at any stage. It is pleasing to report that the complaints procedure now states that the complainant can refer a complaint to the Commission at any stage. We noted the information in the service users guide relating to complaints does not state this information and the organisation would need to ensure that this information is clearly stated in all relevant documents. The complaints procedure is available in WIDGET form. The annual quality assurance assessment (AQAA) stated that since the last inspection the home had received one complaint, which was satisfactorily investigated. Evidence seen demonstrated that the complaint was investigated and a satisfactorily outcome was recorded. The Commission has not been made aware of any complaints about the service. The home ensures that staff receive training on the safeguarding of vulnerable adults at induction and as part of the ongoing training programme. Staff spoken to were aware of the action that should be taken if they suspected or witnessed any form of Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: abuse. There has not been any safeguarding of vulnerable adult referrals made by the service to the local social services authority who deals with safeguarding matters. None of the service users were using the services of an advocate at the time of this inspection. Care Homes for Adults (18-65 years) Page 19 of 28 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 pleasant and well maintained which mean that service users live in a safe and comfortable environment. Evidence: The home is pleasant and spacious located in a residential area about one mile from Chesham town centre. The nearest rail station is Chesham (London Underground Metropolitan Line). There are regular bus services between Chesham and other towns such as, Aylesbury, High Wycombe and Berkhamsted. The accommodation is situated over three floors. The ground floor is comprised of the entrance hall, dining room, lounge kitchen, laundry, two bedrooms, office and WC. Stairs lead to the first floor where there are three bedrooms, bathroom and WC. A further set of stairs lead to the top floor where there is one bedroom and access to the attic. There is a garden on two levels at the rear of the house. Access to the garden is to the side of the house. There is limited space for parking at the front of the house. The lounge is well decorated and furnished with sofas, a coffee table, television and digital video disc player. The dining room was pleasant, spacious with wooden flooring and well lit. None of the bedrooms have en-suite facilities but are equipped with a wash hand basin. Bedrooms seen were personalised with family pictures,soft toys and mementos reflecting the characters of individuals. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The premises were clean hygienic and free from offensive odours. The laundry is sited so that soiled laundry and linen are not carried through areas where food is stored, prepared cooked or eaten. Service users who are able to are supported by staff to do their personal laundry. Care Homes for Adults (18-65 years) Page 21 of 28 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 aims to ensure that there are sufficient numbers of appropriately trained staff to meet service users diverse needs. Evidence: Some service users have difficulty communicating verbally however, staff were able to understand their needs and were attentive and responsive. Staff were observed having a laugh with service users in a kind and respectful manner. Service users looked comfortable and relaxed in staffs company. Staff spoken to were very proud of the high standard of care they were providing to service users. The manager said that one staff had achieved the national vocational qualification (NVQ) direct care at level 3. Other staff members had completed the training but were not issued with certificates because the training company went into receivership. This is unfortunate for staff members who have lost out financially and will have to start the training all over again. The home ensures that the staffing levels are three staff in the morning and in the afternoon and evening shift. At nights there is one waking staff plus one sleeping in. The numbers seem sufficient to meet individuals needs. Examination of the recruitment records for three staff members reflected that thorough recruitment processes had been followed with all the necessary checks Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: undertaken and original documentation available at the organisations human resource office. Training records seen demonstrated that mandatory training is well managed. However, not all staffs training profiles were up to date. Consideration should be made to ensure that all staffs training profiles are kept up to date. Care Homes for Adults (18-65 years) Page 23 of 28 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 home is run and managed appropriately which should ensure that service users and staffs safety is promoted. Evidence: The home is managed by an experienced manager who has been working in the field of learning disability for sixteen years. The manager is a trained nursed but she does not hold the registered managers award. She has been working at the home since June 2008. The manager has not yet started the registration process. It is required that the manager starts the registration process. She is supported by a team of seven support workers who are very committed and understand their roles and responsibilities. Staff said that the manager was approachable and regular staff supervision and monthly staff meetings and service users meetings were held. The manager was complimentary about the staff team and had confidence in the service they were providing to service users. Evidence was seen of reports from regular regulation 26 monitoring visits under taken by the care services manager. The manager reviews the homes quality assurance Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: audit and assesses the action plan in place every three months. A range of health and safety checks are carried out weekly and daily. The fire panel is check weekly and daily safety checks of the building are undertaken. Evidence of regular fire drills taking place was seen and the names of those staff participating in drills were recorded to verify their attendance. We noted that the fire equipment such as fire extinguishers were not serviced in 2008. However, on the day of the inspection we saw evidence that they had been serviced in January 2009. To comply with best practice fire equipment should be serviced yearly. We saw evidence of daily food temperature and fridge and freezer temperatures being maintained. Staff ensure that hot water temperatures in wash hand basins in service users bedrooms and bathrooms and toilets are checked and recorded weekly. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 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 37 8 It is required that the manager starts the registration process. This is to ensure that she is registered with the Commission 15/03/2009 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 7 The home should have clear guidelines in place agreed in a multi-disciplinary forum detailing the reasons why staff should have access to service users pin numbers. The arrangement should be agreed with the service user or their representative, documented and kept under review. Staff should review the practice of using plastic aprons to protect service users clothes at mealtimes. This is to ensure that service users dignity is promoted. Consideration should be made to ensure that all staffs training profiles are kept up to date. To comply with best practice fire equipment in the home should be serviced yearly. 2 17 3 4 35 42 Care Homes for Adults (18-65 years) Page 27 of 28 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). 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