Care Home: Rosedale Rosewood Bungalows

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What the care home does well Before people moved in, the home made sure that it was the right place for them to live. The care records are good so that all staff know exactly how to help people in the right way.The home is nicely decorated and comfortable. People have chosen to paint their bedrooms in the colours that they like. All the rooms are nice.Staff make sure people can go out often.Staff have good training so they know how to help people and how to keep them safe. What has improved since the last inspection? There are new big baths that are better for the people who live here. What the care home could do better: CIC should look at why everyone has checks through the night. If people do need a check there should be a record that says why.Page 11 of 35Care Homes for Adults (18-65 years)It would be better if the home asked doctors if people could have simple medication for pain when they needed it.It would be better if the contracts about how people pay for a shared vehicle were also signed by a relative or advocate.It would be better if bathrooms were more homely. Key inspection report Care homes for adults (18-65 years) Name: Address: Rosedale Rosewood Bungalows 5 - 7 Flaxton Street Hartlepool TS26 9JY 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: Andrea Goodall Date: 1 7 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 30 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 30 Information about the care home Name of care home: Address: Rosedale Rosewood Bungalows 5 - 7 Flaxton Street Hartlepool TS26 9JY 01429269249 F/P01429269249 flaxtons@c-I-c.co.uk www.c-i-c.co.uk Community Integrated Care care home 6 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) : Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places: 6 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Rosedale and Rosewood are run by Community Integrated Care. 6 people can live here. The home is two bungalows that are joined in the middle. It has a large back garden. It is on flat land and has large rooms. This means it is easy for people with a wheelchair to get around it. Everyone has their own bedroom. It is near lots of shops and the town centre. People pay for their own vehicle that they share. Care Homes for Adults (18-65 years) Page 5 of 30 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 30 How we did our inspection: This is what the inspector did when they were at the care home This is what the inspector did when they were at the care home. The inspector talked with the people who live at the home. The inspector had lunch with the people who live here and two staff. She looked at records that the home has to keep, like: care plans staff files medicine records. The inspector looked around the home. This is to make sure it was safe and comfortable. What the care home does well Before people moved in, the home made sure that it was the right place for them to live. The care records are good so that all staff know exactly how to help people in the right way. People can choose to spend time in any part of their house and be alone if they want. The home is nicely decorated and Care Homes for Adults (18-65 years) Page 7 of 30 comfortable. People have chosen to paint their bedrooms in the colours that they like. All the rooms are nice. Staff make sure people can go out often. Staff have good training so they know how to help people and how to keep them safe. What has got better from the last inspection What the care home could do better CIC should look at why everyone has checks through the night. If people do need a check there should be a record that says why. It would be better if the home asked doctors if people could have simple medication for pain when they needed it. It would be better if there was a list of staff, and their initials, who look after peoples medication. It would be better if the contracts about how people pay for a shared vehicle were also signed by a relative or advocate. Care Homes for Adults (18-65 years) Page 8 of 30 It would be better if bathrooms were more homely. 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 Andrea Goodall St Nicholas Building St Nicholas Street Newcastle upon Tyne Tyne and Wear NE1 1NB 01912333300 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 9 of 30 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 10 of 30 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. Prospective residents are fully assessed before they move here so that they know the home can meet their needs. Evidence: Rosedale and Rosewood are two semi-detached bungalows that are connected by a corridor to provide one care home for six people with a learning disability. The people who live here are young adults who are physically fit. The home has a written and pictorial information about the service it provides. This provides clear details of the service and its aims. It is good that the home tries to put information in easy-read and photographs wherever possible to help people to understand it. This home opened in 2001, and there have been no new people to move in since then. Before they moved here the needs of six people were fully assessed by all the health and social care agencies that are involved in their care, including social workers, CIC, health care services, as well as their relatives. Those assessments made sure that the home Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: could meet their individual needs. There are annual reviews of each persons placement here to make sure they are still getting the right service. Care Homes for Adults (18-65 years) Page 12 of 30 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. Overall care planning systems are good, so that staff work consistently to support residents with their individual needs. Evidence: Care plans are records that are used by all care services to show what sort of help each person needs and how staff will provide that care. For example, how to help people with their activities, finances, health care, and behaviour. The sample of care records at Rosedale/Rosewood were detailed and provided clear guidance to staff about how to support each person with their goals and needs. The plans are written in the first person, ie what I want support with and include pictures to help people understand their own records. Examples of goals and needs include: going on holiday; travelling in a vehicle; mealtimes; and positive communication. These show what the person needs support with but also what they can manage themselves, so that their independent living skills are encouraged. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: It is good that people have monthly meetings with their keyworkers to talk about what they have enjoyed, and what they would like to do in the future. A record is kept of what people will need support with for the following month, for example activities, buying new clothes, hair appointments, whether they are still happy with their home and the meals. In this way people can be involved in their own plans, and make decisions and choices about their own lifestyle. The home has risk assessment records to guide staff in how to support people with activities that may involve an element of risk. For example, using transport and safety in the community. These include clear guidelines about how the risks can be minimised. However one person needs support to approach strangers in an appropriate, non-intimate way so that he does not upset them or put himself in danger. There was not a specific or sufficiently detailed risk assessment about this. This means there is not information to help agency or new staff to support him in a consistent and planned way. The people living here are younger adults and generally physically fit. However care records show that each person is checked every two hours through the night by staff entering their room with a torch. In discussions with staff it was clear that this practice disturbs some people during their sleep, and this could lead to them becoming tired which could have an impact on their behavioural needs. There were no risk management records to show the reasons why this practice is carried out with every person. Care Homes for Adults (18-65 years) Page 14 of 30 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. People are supported to lead a fulfilling lifestyle so their rights to individuality, choice and privacy are respected. Evidence: The six people who live here have a variety of day time occupations. Some people attend local day centres for activities such as cooking and horse riding. One person has a work placement at a local pony club a couple of days each week. It is clear that staff also try hard to ensure that people do have the chance to go out as often as possible. This might be to planned activities, shopping trips to the town centre, or walks along the beach. In this way people get out of the home every day. The home is good at supporting people to keep in touch with their family, if they have any, and some people go to their parents home for visits. The home is also good at making sure people are part of their local community. They enjoy visits to local pubs, Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: shops and cafes. People also enjoy evening activities such as karaoke nights at a pub and a weekly disco. In this way they have opportunities to meet new people. People are encouraged to be involved in some household tasks, such as clearing tables and dusting, but most people are not motivated to do this and could be involved in more. People are also involved from time to time in weekly grocery shopping, for example usually two staff and one resident do this at a large supermarket. Some people would find this difficult because of their behavioural needs, but everyone also has the chance to do some shopping for their own personal items. The weekly menus are designed by staff and are based on their good knowledge of peoples preferences, as well as healthy diet options. It was clear from records and discussions with staff that people enjoy a wide range of dishes and also enjoy occasional take-aways and meals out. In this way they enjoy a varied diet that suits their preferences and dietary needs. Care Homes for Adults (18-65 years) Page 16 of 30 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. People receive good support so that their personal and health care needs are met. Evidence: All of the people who live here need some support with personal care to varying degrees. For example verbal prompts and supervision to help people get dressed, washed and have baths. It is good practice that there are three male support staff (and one more to start in the near future). This means on most days there will be a male staff on duty. This is beneficial as it provides gender-appropriate support for the five male residents, and most men living here respond well to male role models. Health care records show that the home ensures that people have access to the right health care services when required. For example, GP,dentists, dietitians and psychiatry services. None of the people who live here have been assessed as able to manage their own medication. Medication is only managed by the staff who have training in safe handling of medication. At this time the list of designated staff is not up to date and does not include their initials. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Medication is delivered to the home by a pharmacist each month. It is then securely stored in each bungalow, and recorded on medication records when given to residents. A representative of the Provider carries out regular audits of the home, including the medication system, to make sure it is being managed in the right way. At this time the home has not sought consent from the GPs of some residents about over-the-counter remedies such as simple painkillers or cough syrups. This means that if those residents had a pain or a temperature staff would not be able give them any simple medication to relieve this. Care Homes for Adults (18-65 years) Page 18 of 30 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. Overall the homes procedures and staff training make sure that people are protected from abuse. Evidence: The home has good information for people about how to make a complaint. This includes picture information about their rights and the complaints procedure, which are kept in their files. There is also a video about what to do if they are not happy with the service. This was produced by people at a local day centre operated by Hartlepool Borough Council. Some of the people who live here have limited communication skills and would find it difficult to comprehend the concept of a complaints procedure. However everyone is able to express dissatisfaction with a situation either through speech, gesture or mannerisms. Staff have built up a very good understanding of different residents likes, dislikes and communication needs. There have been no complaints received by the service or by CQC over the past year. All staff have had some training in protection of vulnerable adults. Although staff were not fully aware of the new local council safeguarding adults arrangements, there is a poster in the office that gives them this information. Staff were clear about how they would report any poor practice through CICs processes. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Following recommendations at the last inspection there have been some improvements to the records of residents purchases and property. Each of the people who live here contributes their mobility allowance towards the cost of a shared vehicle. There is a Vehicle Agreement (a written contract about financing the vehicle) that has been signed by each resident. However this agreement is written in very complex, legalese language and could not be comprehended by the people who live here. There are no signatures of relatives or other advocates to show that this has been considered and agreed in the residents best interests. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well decorated, well maintained, comfortable and safe environment so they enjoy a good standard of accommodation. Evidence: The two modern bungalows are very well decorated and well maintained. They provide a very good standard of accommodation for the people who live here. Each bungalow has three bedrooms, a lounge, dining room, large well-equipped kitchen, bathrooms and toilets. The bungalows are decorated in modern, neutral colours that suit the age of the people who live here. There is a spacious driveway and large, private back garden for residents to use in better weather. Although no-one currently has mobility needs, all areas of the bungalows are accessible by people with such needs so it could offer people a home for life even if their physical needs changed. Each person has a good sized bedroom that is decorated and furnished to their individual taste. Bedrooms have been highly personalised, and people make good use of their own rooms for their hobbies and interests. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: A previous requirement about fire doors has been addressed, and there are now better door-holding devices fitted to some doors which would release in the event of a fire. Other improvements to the home include new baths that are a better size for the people who live here, and new dining furniture is planned for the pleasant dining rooms. The bathrooms in both bungalows are large and well-equipped but both are a little bare. There are boxes of protective gloves and temperature records on display which give the bathrooms a rather clinical appearance compared to the rest of this well decorated home. Staff carry out the routine daily household tasks, and try to involve residents in these wherever their capabilities and motivation allow. Staff were clear that the activities of residents are the priority and that housework can be carried out at times to suit the people who live here, for example ironing is carried out during the night. All areas were very clean and hygienic. The home has a central laundry room which is well-equipped. Care Homes for Adults (18-65 years) Page 22 of 30 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. People are supported by suitable, competent, well trained staff so that their needs are well met. Evidence: The care staff team currently consists of the manager, a senior support staff and a team of around nine support workers. This allows for three staff on duty throughout the day and evening to support the six people who live here. The home provides two staff on night time duty, one of whom sleeps-in. This level of staffing provides sufficient staff to support people when they are in the house. CIC is an equal opportunities employer, and the current staff team has a good mix of experience, gender and age. Several staff have worked here for some years, so there is good continuity of care for the people who live here. There is clearly a good relationship between residents and staff, and people enjoy spending time with staff. There have been only a couple of changes to the staff team over the past year, for example one staff has swapped with a support staff from another CIC care service nearby. The home has access to bank staff and tries to ensure that the same bank staff are used for the continuity of care for the people who live here. However the home has Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: also had to use agency staff recently due to staff vacancies and holidays. CIC uses robust recruitment and selection processes to ensure that all new staff have been checked before they start work here. These includes references, health declaration and a CRB Disclosure (police check). It is good practice that residents are invited to meet prospective staff, and one person was recently involved in interviews of applicant staff. It was stated that all staff have achieved a national qualification in care called NVQ level 2, which is very good practice. The home keeps certificates of training in individual personnel files. CIC also has a good computer training management tool that identifies when staff need updated training in health & safety matters. Staff said that they enjoy working at Rosedale and feel that CIC provides a very good service for the people who live here. They said that they had good opportunities for training, but were concerned that they now have to pay for their own travel to get to mandatory training courses which are held some considerable distance from the home in Newton Aycliffe. Care Homes for Adults (18-65 years) Page 24 of 30 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 in a satisfactory way so that it promotes the welfare of the people who live here. Evidence: The home has a registered manager who has several years experience of working in social care settings. She is supported by a senior support staff and supervised by a service manager of CIC. Over the past few months the manager has taken responsibility for the management oversight of a neighbouring care service, also operated by CIC. This has meant that the at times the senior support staff has deputised on behalf of the manager, but there has been no increase of staff to support the staff team. It was anticipated that this would be a short-term measure, but there is no indication of when this situation will be resolved. However in the meantime the manager continues to have some input into Rosedale and at the time of this inspection had accompanied a resident who was away on holiday. CIC uses a number of quality monitoring tools to audit the service it provides at Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Rosedale. These include visits by a representative of CIC to check on the homes operations. People are encouraged to express their views, wherever capabilities allow, at their monthly keyworker meetings where they can comment on things they like or do not like. CIC also uses an annual survey to get residents views. However these are not actually completed by residents and there is no indication of who has completed them on their behalf, that is whether staff, relative or other. Also the surveys are not dated so its difficult to know if they are current. The views of relatives are also sought through an annual questionnaire (although these are also not dated). The most recent surveys were very positive and included comments such as its very welcoming when I visit, its always clean and tidy, and staff look after residents very well. CIC carries out regular health & safety audits to make sure that the home continues to protect the welfare and safety of the people who live here. Maintenance and service checks are carried out, including fire safety, food temperatures and water temperature checks. The hot water temperature is checked every time someone has a bath to ensure that it is safe (that is, around 43 degrees Centigrade). At the time of this inspection the hot water records showed that the temperature is quite low at around 38-39 degrees Centigrade, which could be too cool for some people. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 9 13 There must be a review of the reason for the night checks of all of the young people who live here, and clear risk management records to justify this practice. 01/12/2009 This is to ensure that any risks to people are recorded and managed in a planned, purposeful way. 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 9 It would be better if there was a specific detailed risk assessments to guide staff in how to help people to Page 28 of 30 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 approach strangers in an appropriate, non-intimate way. 2 3 20 20 Consent should be sought from the GPs of every resident for over-the-counter remedies, including simple painkillers. It would be helpful for the home to have an up-to-date list of the staff, including their initials, who are designated as responsible for the management of peoples medication. The Provider should ensure that financial contracts undertaken on behalf on residents, for example the Vehicle Agreement, can clearly demonstrate that a representative or advocate was involved to ensure that this is in the best interests of each individual resident. Protective gloves and temperature records could be discreetly stored within bathroom cabinets to support the dignity of the people who live here. Consideration could be given to how the bathrooms could be cosmetically improved in line with the rest of the homes furnishings. It might be better if annual surveys were dated for future reference. The home should check that the hot water to baths can achieve 43 degrees Centigrade. 4 23 5 27 6 27 7 39 8 42 Care Homes for Adults (18-65 years) Page 29 of 30 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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