Care Home: Redstone House

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What the care home does well The home has thorough admissions procedures and shows it is meeting the needs of service users well. It demonstrates that it is service user led,responsive to their needs and the care and support provided promotes independence,confidence,community presence and a varied and active lifestyle as is appropriate for the ages of service users. Health needs are well met and contact is maintained with a range of health professionals. Records show that the home obtains good results in reducing incidents of challenging behaviour and helping service users to become more settled. Communication with families is kept up and they are encouraged to visit and feel welcomed by the staff. The environment is clean,safe,well maintained and homely. Meals are healthy,service users contribute to menu planning and menus are agreed by a dietitian Staff are responsive to service users needs and understand their communication methods.Staff are well trained and supported and have receive training on recent new legislation such as the Mental Capacity Act. What has improved since the last inspection? Since the last inspection which was the first for this service the manager has become registered with the Commission. The activities timetable has become better planned and new activities have been introduced. Service users have more opportunities to give their views on the running of the home and can choose to be involved in the recruitment process and staff meetings The environment has been improved.There has been some redecoration and refurbishment to the living area and service users bedrooms. What the care home could do better: A review of the care plan format is required to make the plans more accessible,person centred and to include a system whereby documents are signed and dated whenever needs or assessments are reviewed. All medication that is out of date must be disposed of and all handwritten entries on medication records must be signed and dated by staff trained to administer medication. Key inspection report Care homes for adults (18-65 years) Name: Address: Redstone House 43 Redstone Hill Redhill Surrey RG1 4BG     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: Deborah Sullivan     Date: 0 8 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Redstone House 43 Redstone Hill Redhill Surrey RG1 4BG 01737762196 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: redstonehouse1@aol.com Oregon Care Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Redstone House is a detached property located near the town centre of Redhill, Surrey. The service can provide accommodation to four adults with learning disabilities. All the bedrooms are for single occupancy and are of a good size. On the ground floor there is a communal lounge/dining room, a kitchen and separate utility room. There is a conservatory that leads from the lounge to the rear of the house to a paved garden. Parking facilities are available to the front of the house. The range of fees for the rooms is #1,663 per week to #2,307 per week. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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 key inspection of Redstone House took place over five hours,during the visit time was spent with staff on duty,a service user and the registered provider who was present for part of the time and received feedback on the inspection.Short notice of the visit was given to make sure that someone would be at the house as service users lead an active lifestyle and are often out with staff. During the visit the standard of the environment was inspected and a range of records and documentation were examined, including care plans,medication records and staff training information. Information provided on survey forms and in the AQAA(Annual Quality Assurance Assessment) document completed by the registered manager has also been used to inform and as evidence for this inspection. The last key inspection of the service took place on 9th July 2007. Care Homes for Adults (18-65 years) Page 5 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 6 of 28 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 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 8 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. Information is available about the service that is accessible to service users and their representatives and the assessment and transition process is thorough. Service users are welcome to visit the home before choosing to move in. Evidence: No new service users had been admitted to the home since the last inspection,three people were in residence and there was one vacancy.Pre admission information was included in service users personal files.All the service users are sponsored by local authorities and health and social care professionals had contributed to the assessment and admission process. Information provided by the registered manager on the Annual Quality Assurance Assessment document states that there are well planned transitions and service users spend time at the home and with staff before they move in. Two survey forms from service users who had been assisted with filling them in said that they had been asked if they wanted to move to the home and had received information about it. Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: Information about the home is available pictorially for service users and there are pictorial contracts as well as written ones on personal files. Care Homes for Adults (18-65 years) Page 10 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. Each service user has an individual plan of care,the plans require review as the information is not easily accessible for service users or staff and in some cases evidence of review was lacking. Service users are consulted about the service they receive and can participate in the day to day running of the home. Evidence: The care plans of the three service users were inspected.There was a large amount of information on the files some of which was of good quality about health and personal care needs,risk assessments,evidence of internal and care management reviews and daily recording.Some information was presented pictorially,although it was not always easy to locate information as a lot of old and current paperwork was together in the files and not clearly divided.The main care plan giving daily support guidelines for staff was not sufficiently person centred and did not give enough detail as to how support was to be provided,there was some evidence of service user consultation and choices Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: being recorded.Staff spoken with clearly had good in depth awareness of preferences,needs and likes and dislikes but the written information sometimes did not back this understanding up or evidence that it was available for all staff. There was evidence of risk assessments being updated and internal reviews taking place but not all had been signed or dated, the risk assessments were of a good standard overall. All personal information seen was being stored confidentially.Where there was evidence of reviews being held by care management the outcomes were recorded as being positive,a fairly recent review recorded that all were pleased with the service users progress. Service users have opportunities to contribute to the running of the home,they are consulted about menus,activities,the decor of their rooms and receive the homes annual internal quality assurance questionnaire.A relative who returned one of the Commissions survey stated that despite the service users lack of speech that .......Her opinion is always sought on the subject of activities and holidays. Care Homes for Adults (18-65 years) Page 12 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. Service users are supported to take part in a range of activities at home and in the community and lead an active lifestyle. The home values and supports contact with relatives and friends. Meals are well balanced and healthy,service users contribute to menu planning. Evidence: Service users lead a varied and active lifestyle and each person has an individual activities programme.On the day of the visit two service users were at college,one was at home in the morning and attending an activity in the afternoon. Activities include swimming,trampolining,college,going to the cinema,horse riding and bowling.There are evening and weekend social outings arranged. Each service user needs either two to one or one to one support depending upon the activity and their individual Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: needs,funding is provided by local authorities to allow for the correct level of one to one staffing required.The provider said that three vehicles are available,shared between two homes, importance is given to recruiting staff who can drive and swim so that all activities can be fully facilitated.One service user was going on holiday to Butlins with staff the following week and days out were planned for others. The service user present was watching TV some of the time and very keen on watching DVDs so staff were supporting them to choose the one they wanted. Independence is promoted and service users assist with tasks such as bringing their own washing to the laundry. Contact with relatives is well supported,a survey form from a relative included the comment that the service user -- Is encouraged to make phone calls and members of the family and friends are always welcomed when they visit and given hospitality. Two service users who had been supported with filling in surveys put that the home enabled them to do what they chose,one had signed they liked horse riding and the disco. During the visit staff on duty were respectful towards the person present and attentive to their needs. Meals are healthy and varied and service users contribute to menus which are developed in consultation with a dietitian and dietary needs taken into account.Staff said that one service user who had needed to loose weight had done very well in achieving this goal through exercise and healthy eating.The main meal is in the evening with a light lunch.Staff said that service users are not restricted in entering the kitchen but always do so under supervision,they can choose to prepare their own breakfasts of cereal,if they choose a hot breakfast staff prepare it. Care Homes for Adults (18-65 years) Page 14 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 health and personal care needs of service users are well met and independence is promoted. Health concerns are promptly addressed and advice sought from health professionals. Medication procedures need to be improved upon to ensure the protection of service users. Evidence: The health and personal care needs of service users are reflected in the care plans,it is evident that health needs are well recorded and contact with a range of health professionals such as psychiatrists,community nurses,a dietitian and GPs is maintained. Service users have complex needs and can exhibit behaviours that challenge, behavioural guidelines and risk assessments have been completed although it was unclear when some had last been reviewed.Staff spoken with and observed were confident in supporting the service users and understood how to deflect and manage challenging behaviours. The home demonstrates good outcomes in the Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: management of and in reducing difficult behaviours as was evidenced by reading a care management review where positive progress had been made.Complimentary comments were also made on a relatives survey and staff gave examples of progress such a service user who was now more comfortable in accessing the community. Service users mainly communicate non verbally and staff were using Makaton to communicate with the service user at home and understood their demeanor and gestures. Service users all require support with personal care,they are encouraged to be as independent as possible and to attend to their own personal care and choose clothes to wear each day.A relative wrote on a survey that.......She is encouraged to be a modern young lady,regarding make up,hairstyle,dress and manners. Procedures are in place for the administration of medication,it is securely stored but two items for external use only were found to be out of date,they were immediately removed by a staff member.Medication recording sheets were correctly completed and staff administering medication are receive medication training.A list of staff trained to give medication with their signatures is maintained.One handwritten entry for a medication recently prescribed had not been signed. A care plan included relatives wishes in the event of the death of the service user. Care Homes for Adults (18-65 years) Page 16 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 policies and procedures in place for the protection of service users,some of the information needs review to make it clearer for staff. A complaints procedure is available and service users and others can feel confident that any concerns will be listened to. Evidence: The home has a complaints procedure that is available in a pictorial format and is on display in the home.No complaints were recorded as having been received since the last inspection and no complaints had been received by the Commission. Service users need support in order to raise concerns,staff understand their methods of communication and two survey forms from service users said that they know how to complain. One safeguarding vulnerable adults alert has been received since the last inspection,it had been reported by several staff to the manager and was promptly referred by the manager to the local authority.This demonstrates that staff are aware of what constitutes abuse. Staff receive internal safeguarding training and there is are safeguarding policies and procedures.The home was advised to obtain an updated copy of the Surrey multi agency safeguarding procedures and to review its own procedures to make them clearer for staff as they are currently divided into procedures for different kinds of abuse. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: Due to the nature of the service and the needs of service users behavioural risk assessments and guidelines are in place for each person,during the visit staff demonstrated that they had good understanding of behavioural triggers and how to minimise risk of service users harming themselves or others. Care Homes for Adults (18-65 years) Page 18 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. Service users live in a comfortable,clean,well presented and homely environment. The home meets the needs of service users and is safe. Evidence: The home is clean,well decorated and furnished and well maintained with a homely feeling. One service users bedroom was being redecorated and refurbished in colours of their choice and a TV was being fitted on a wall fitting during the visit ,it was to have a protective screen that would maintain the safety of the service user whilst allowing programmes to be watched clearly.During the redecoration the service user was being temporarily accommodated in the attractive empty bedroom.All bedrooms were clean,light and airy and personalised to the wishes of the service user. There is a large lounge/dining area leading onto a conservatory which overlooks the good sized well kept garden which has a patio area.There is also a small quiet room with a TV upstairs that can be used when service users need time alone or with staff in private. Attention has been given to the use of safe furnishings and making the environment as hazard proof as possible. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: The garage is in the process of being converted into another room for leisure activities. The service user at home was accessing the parts of the building they wished to with staff support and supervision and appeared comfortable in the environment. Care Homes for Adults (18-65 years) Page 20 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. Service users are supported by a confident,well trained and well supported team of staff. The home has recruitment procedures in place to protect service users. Evidence: The home is well staffed and the daily staffing is arranged so that there is provision for one to one, or two to one support for activities and for sufficient cover for service users at home,it can vary on a daily basis. Three staff were on duty in the morning, one was out with service users,the registered manager was on leave but one person on duty at the house had management experience in another service and the other was a senior carer.There was a change over at 2 pm. At night there is sleep in staff cover with on call back up. Staff are responsible for meal preparation and cleaning. The home is fully staffed,the provider said that there is consistency of care and agency staff are never used,sometimes bank staff cover shifts and they are familiar with service users. The home employs a diverse staff team and there is a mix of male and female staff. The staff training plan and schedule was read and the training file showed that certificated core and service specific and specialist training takes place,core training is regularly renewed.Other training includes equality and Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: diversity,challenging behaviour,epilepsy and the Mental Capacity Act.The majority of the staff hold an NVQ in care at level two or above. Some discussion about recruitment took place with the provider who said that there is little staff turnover,staff are recruited to match service users needs and processes are thorough.The Annual Quality Assurance Assessment Document tells us that service users have opportunities to be involved in the recruitment process. A member of staff said that the recruitment procedure had been very thorough and they had needed to wait whilst their satisfactory CRB and references were obtained before starting work. Induction had been given that was supportive and enabled them to feel confident in working alone and there had been plenty of training.Regular staff meetings are held and a staff member said they could always raise any issues in between meetings with the manager. Surveys returned by two service users said that they were well treated by staff,they were listened to and staff acted upon what they said. The three staff who returned surveys all put that recruitment checks had taken place,they were well supported,given enough information on peoples needs,and they had received induction.Staff observed during the visit and spoken with were knowledgeable about individual needs and routines and how to manage behaviours that challenge effectively. A survey form from a relative commented that since living at Redstone House the manager and staff had been sensitive to the difficulties that a service user had with their behaviour with positive results. Care Homes for Adults (18-65 years) Page 22 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 efficiently in the best interests of service users and staff. There are good internal quality assurance systems in place and the views of service users are sought. Evidence: Since the last inspection the homes manager has become registered with the Commission,they are experienced and well qualified for the role.The manager is supported by a deputy manager. The home is being well run and service users are settled there,the majority of comments on survey forms were complimentary, especially about the relationships service users have with staff and the manager and their skills in supporting them. Staff spoken with and who returned surveys felt well supported and trained and that managers were approachable.There is a warm and friendly atmosphere in the home and it is clearly service user led,adapting the environment and staffing levels to meet Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: needs and if they change. Internal Quality assurance is taken seriously,annual surveys of service users and other stakeholders take place,some 2008 survey forms were read and the feedback was positive,the results had been collated. Service user meetings are held regularly and recorded Regulation 26 visits take place monthly.Policies and procedures to ensure safe working practices are observed are in place and during the visit staff were observed to be following them,any item such as cleaning materials that could present a risk to service users was being securely stored. Records required for the effective,safe and efficient running of the home are of a good standard whilst improvements are needed to make some of service users personal information more accessible and person centred and to show when it was last reviewed. The service is continuously looking at how it can develop and a development plan has been prepared for 2009/10. Care Homes for Adults (18-65 years) Page 24 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 25 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 6 15 The registered person shall ensure that the assessment of the service users needs is kept under review and revised at any time when it is necessary to do so. Individual care plans should be reviewed and brought up to date at regular intervals with clear evidence available of when this took place. 30/09/2009 2 20 13 The registered person shall 17/07/2009 make arrangements for the recording,handling,safekeepi ng,safe administration and disposal of medicines received into the care home. All out of date medications must be disposed of and handwritten entries on medication records must be signed. Care Homes for Adults (18-65 years) Page 26 of 28 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 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. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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