Care Home: Rough Lee House

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What the care home does well Members of staff were friendly and promoted dignity and respect for people using the service. One person said, "The staff are really nice." One visitor said, "The staff are really good, very committed and very caring." Comments written on the surveys completed by people using the service included, `I have been here a long time, it`s good` and `Staff are very helpful`. People living at the home could pursue their own interests and hobbies or choose from a range of leisure activities organised by staff and volunteers. Holidays were also arranged for people who wanted to go away for a short break. People were also encouraged to be involved in the local community. A few people were doing courses at the local college and another person explained how she enjoyed helping people by doing voluntary work at a local charity. The home is spacious and suitable for wheelchair users. One person said, "We have a beautiful home." Other people told us that they liked their rooms. All the people asked said the meals were good. One person said, "We`ve got a very good cook." What has improved since the last inspection? The requirements made at the last key inspection of 19 May 2009 had been addressed by the random inspection of 18 November 2009. However, the manager has taken the following action to comply with the good practice recommendations made at the last key inspection. A written report is completed during every shift which provides details of social activities and the care given to each person using the service. This ensures that all members of staff have up to date information about each person. Clear written instructions were in place explaining when people needed to take their `when required medication.` This ensures that people are given their medication when they need it. What the care home could do better: It is strongly recommended that the manager reviews and increases staffing levels at the weekend. This will enable people using the service to access leisure activities in the community if they so wish. Induction training should be further developed to ensure it meets the `Skills for care` standard. This will help new members of staff to acquire the knowledge they need in order to provide person centred care for people using the service. Key inspection report Care homes for adults (18-65 years) Name: Address: Rough Lee House Rough Lee Road Accrington Lancashire BB5 2LR     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: Susan Hargreaves     Date: 1 3 0 5 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Rough Lee House Rough Lee Road Accrington Lancashire BB5 2LR 01254393152 01254393152 ac.buckley@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Alex Group Name of registered manager (if applicable) Andrea Catherine Buckley Type of registration: Number of places registered: care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: 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 categories: Physical disability - Code PD The maximum number of Service Users who can be accommodated is: 15 Date of last inspection Brief description of the care home Rough Lee House offers 24-hour personal care for up to 15 younger adults with physical disabilities. The home is a detached purpose built property with large gardens and a car park. All accommodation and facilities are located on the ground floor. Communal rooms include a conservatory and spacious lounge with dining area. These are suitable for a variety of both individual and group activities. Accommodation is provided in 11 single and 2 twin-bedded rooms. There are no en-suite rooms but bathroom and toilet facilities are close to all rooms. Rough Lee is close to Accrington, local amenities and public transport. The current fees charged at Rough Lee are £391.80 per week. Additional charges are Care Homes for Adults (18-65 years) Page 4 of 28 1 8 0 5 2 0 0 9 15 Over 65 0 Brief description of the care home payable for transport, toiletries, holidays, trips out and stationary. A statement of purpose and service user guide was available to prospective service users and their relatives on request. 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: A key or main unannounced inspection, which included a visit to the home, was conducted at Rough Lee on 11 May 2010. As part of the inspection process we looked at all the information we have received about Rough Lee since the last key inspection which took place on 19 May 2009. This included a random inspection on 18 November 2009. The purpose of this inspection was to monitor compliance with the requirements made at the key inspection relating to medication and staff recruitment. Information about the last key and random inspections can be obtained from Rough Lee or www.cqc.org.uk The manager completed an annual quality assurance assessment several weeks before this visit to the home. This document is a self-assessment that focuses on how well outcomes are being met for people who use the service. It also gives us some numerical information about the service. Care Homes for Adults (18-65 years) Page 6 of 28 Ten completed surveys were returned from people using the service and ten from members of staff. At the time of this visit fourteen people were living at the home. A tour of the premises took place and we looked at staff files and care records. We also spoke to members of staff on duty and people who use the service. Discussions also took place with manager and deputy manager regarding issues raised during the inspection. Care Homes for Adults (18-65 years) Page 7 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 8 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 9 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 10 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. A thorough admissions procedure ensured the social and healthcare needs of of people using the service were identified and met. Evidence: A copy of the statement of purpose and service user guide is available to people who are considering using the service and their relatives on request. These supply information about the care and facilities provided at the home. There have been no permanent admissions to the home for two years. However, the manager explained that people who are considering using the service are encouraged to visit the home and meet the other people living there. They are also invited to stay overnight or for a weekend to help them to decide if they would like to live at Rough Lee. Although information about the persons social and healthcare needs is provided by social services we were told that during the pre-admission visits further assessments are completed. This process checks that the staff at Rough Lee can fully meet the needs of the person before they are admitted to the home permanently or for respite care. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: Pre-admission assessments also provide important information for the development of the care plan. Care Homes for Adults (18-65 years) Page 12 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. People using the service were encouraged and supported to make decisions about their lifestyle and the care they received. Evidence: We looked at the individual care plans of two people who use the service. These plans identified the social and healthcare needs of each person and explained what members of staff needed to do in order to meet these needs. Information about peoples individual likes and dislikes was was also included in their individual care plans. One person had written about the people and things that were important to her and provided details of the help she would like from care workers. This ensures that people are cared for in the way they prefer. Appropriate risk assessments including ones for falls, nutrition, moving and handling and activities outside the home were in place. Guidance for staff to follow about how to manage identified risks was also included in the care plans. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: A written report about social activities and the care given was completed during each shift. This ensures that all members of staff have up to date information about each person in order to provide continuity of care. Care plans and risk assessments were reviewed regularly and up dated when the needs of the person changed. Where possible the people using the service were involved in planning their care and signed the care plan to indicate their agreement with the care provided. People using the service were encouraged and supported by members of staff to make decisions about their lifestyle including daily routine and leisure activities. These were recorded in their individual care plans to ensure all members of staff had this information. Surveys completed by people using the service stated that they decided what they wanted to do each day. Care Homes for Adults (18-65 years) Page 14 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. Peoples choices were respected and they were supported by members of staff to have a fulfilling lifestyle. Meals were wholesome and appetising and people enjoyed them. Evidence: People using the service were encouraged and supported to take advantage of educational and employment opportunities. Two people regularly attended the local college and one person did voluntary work for a charity. People using the service could also choose to take part in a variety of leisure activities organised at the home. These included baking, bingo, exercises and craft activities. Visits to local amenities were also arranged these included, swimming, shopping and going to the cinema and bowling. Holidays were organised and destinations were decided with people using the service at the residents and friends support group meetings. One person told us they were going to Southport later in the year. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: Local clergy regularly visited the home and offered Communion or Mass to people who wished to practice their faith in that way. A Church choir also visited the home every month. A number of people who used the service regularly attended local Church services. During the morning of this visit we saw a care worker doing exercises with some people using the service. Others were pursuing their own interests such as listening to music, watching television, looking at catalogues or using computers. During the afternoon several people enjoyed baking. However, several members of staff who completed the survey considered that the home would be better if people using the service were taken out more often. We were also told that people did not go out at the weekend unless their relatives visited because only two members of staff were on duty. Discussion with members of staff and people using the service confirmed that the daily routine was flexible and people could choose what they wanted to do each day. People using the service and members of staff said that visitors were welcomed into the home at anytime and offered refreshments. All the people asked said the meals were good. One person said, Weve got a very good cook. The meal served at lunchtime looked wholesome and appetising. Lunch was unhurried allowing people time to socialise and enjoy their meal. Members of staff were also observed assisting people in a sensitive manner. The menus were varied and people were offered a choice of food for all meals. A bowl of fresh fruit was available on the dining tables for people to help themselves when they wanted. Care Homes for Adults (18-65 years) Page 16 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. People using the service were cared for in a manner which promoted their privacy and dignity. Medication was managed safely. Evidence: Personal care was carried out in the privacy of the persons own room or the bathroom. Members of staff were observed attending to people in a polite and friendly manner. One person said, The staff are really nice. Information about the healthcare problems of people using the service along with the care and support they needed from members of staff was included in the care plans we looked at. There were also records of the involvement of GPs and other healthcare professionals including optician, chiropodist and dentist in the care of people who use the service. Medication was stored correctly and administered by members of staff who had received training in the management of medication. We looked at the records for the management of medication. These included a record of medication received into the home and a record of unused medication returned to the pharmacy. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: We checked a sample of medication administration records and found that these had been completed correctly. We also checked the amount of medication in stock against the amount administered and found this to be correct. This confirms that people have been receiving their medication as prescribed by the doctor. A number of people were prescribed medication to be taken when required. Written instructions for staff to follow stating the signs and symptoms each person experienced when they needed this medication was in place. This ensures that people are given their medication when they need it. We looked at the records of how medication was checked by the manager. This was done every month and involved checking all aspects of the management of medication. Care Homes for Adults (18-65 years) Page 18 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. Complaints would be taken seriously and investigated. Members of staff had the training necessary to ensure people who use the service were protected from abuse. Evidence: A copy of the complaints procedure was included in the statement of purpose and service user guide. An easy to read version of this procedure was also available in order to ensure people using the service knew how to make a formal complaint. According to the AQAA no complaints have been made to the manager in the last year. No complaints have been made directly to the Commission. People using the service who completed surveys stated that they knew who to speak to if they were unhappy about anything. One person told us they would make a complaint if needed. The manager told us in the AQAA that policies and procedures for safeguarding vulnerable adults were in place. We looked at the safeguarding procedure displayed in the staff room. This gave clear directions and included relevant telephone numbers for social services and the Care Quality Commission. Having clear procedures in place helps to ensure that all members of staff know the correct action to take if allegations of abuse are made to them. Discussion with two members of staff confirmed that they had received training in safeguarding vulnerable adults. They both said they would report any concerns to the manager immediately. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was equipped, furnished and decorated to a high standard and provided a very pleasant and safe place for people using the service to live. Evidence: A tour of the premises confirmed that the home was clean, tidy and well maintained. All areas of the home were accessible to people using wheelchairs. This provided a safe and comfortable place for people using the service to live. Bedrooms were suitably furnished so that people using wheelchairs could reach their drawers and wardrobe. All the bathrooms had assisted baths and a wet room with shower enabled people using wheelchairs to have a shower. A ceiling tracking system was available in one of the bedrooms and a bathroom in order to promote the safe moving and handling of people using the service. Communal areas were very spacious and suitable for a variety of social and cultural activities. People using the service were encouraged to bring personal items for their bedrooms to meet their own needs and preferences. This included pictures for the walls, photographs, televisions, music centres and personal computers. The grounds and gardens were well kept and accessible to all people using the service. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: All the laundry was done at the home. A suitable washing machine and tumble dryer ensures clothes are washed promptly and returned to people using the service. Gloves and plastic aprons were available for members of staff to use in order to protect themselves and people using the service from infection. Members of staff had also received training in infection control procedures. 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. Members of staff are encouraged to acquire the skills and knowledge necessary in order to meet the needs of people using the service. Recruitment procedures are thorough. Evidence: The duty rota provided details about the grades and number of staff on duty for each shift. A number of staff who completed surveys expressed concerns about staffing levels. Comments included, more staff should be provided to cover for holidays and more staff would be good because its hard to find time to interact with clients during the evening. We were also told that the weekend cook had retired and a replacement had not been appointed. This meant that the two care workers on duty were also required to prepare meals. Only having two care workers on duty at the weekend also meant that people using the service could not go out at the weekend unless they were accompanied by a relative or friend. The manager was advised to review staffing levels at the weekend in order to ensure that peoples social care needs were met as well their personal and healthcare needs. We looked at the files of two members of staff and a volunteer worker appointed since the last inspection. These files indicated that all the required information had been obtained before these members of staff had started working at the home. These Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: included two written references and a Criminal Records Bureau check. These checks ensure that people who use the service are protected from the employment of unsuitable staff. Discussion with members of staff and the manager confirmed that training for all members of staff was encouraged. Induction training was in place for new members of staff. Although this provided only basic information surveys completed by members of staff stated that induction training given them the information they needed to to their job. However, the manager was advised to further develop this training in order to ensure that new staff had the necessary skills in order to provide person centred care for people using the service. Members of staff said they had received training in basic food hygiene, moving and handling, medication, infection control, safeguarding vulnerable adults and first aid. In addition to this most of the care workers had National Vocational Qualifications in health and social care at level 2 or above. 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 views of people using the service are considered when decisions about the care and facilities provided at the home are made. Evidence: The registered manager is experienced in caring for younger adults with disabilities. She keeps up to date with current practice by attending relevant training, reading care journals and using the internet. Discussion with the manager and deputy manager confirmed that they were committed to running the home in the best interests of the people living there. A meeting with people using the service is held every Friday. At these meetings activities and any new or updated procedures are discussed. The people using the service were recently asked to give their views about the home by completing satisfaction questionnaires. Several completed ones were available and showed mainly positive responses to the questions asked. According to the AQAA as a result of listening to people using the service a display board has been provided to advertise the weekly activities taking place at the home. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: A member of the managment committee consistently visits the home every month and provides a written report for the manager. This ensures the manager receives the support and supervision she needs in order to ensure the home is being run in the best interests of the people using the service. The manager has told us in the AQAA that policies and procedures for safe working practices are in place. These help to make the sure the home is a safe place to live and work. Fire alarms and emergency lighting are tested weekly. A fire drill is held every six months. We looked a the records of the routine servicing of equipment. These included up to date gas safety and electrical installation certificates and evidence that the testing of small electrical appliances is carried out annually. 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 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 13 Sufficient staff should be available at the weekend in order to enable people using the service to access leisure activities in the community if they so wish. This will ensure they are part of the local community and prevent social exclusion. It is strongly recommended that staffing levels at the weekend are reviewed and increased. This will ensure there is sufficient staff available to enable people using the service to visit local amenities if they wish. Induction training should be further developed to ensure it meets the Skills for care standards. This will help new members of staff to acquire the knowledge they need in order to provide person centred care for people using the service. 2 33 3 35 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. 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