Care Home: Shalom Home

What the care home does well The resident that we spoke to felt that staff were supportive and responsive to individual needs. The care plans indicated that people were encouraged to engage in fulfilling activities and maintain contact with family members and friends. What has improved since the last inspection? A substantial number of requirements and recommendations were issued within the last key inspection report. It was noted that the service had sought to make improvements with care planning, risk assessments, staff training, organisation of any individual financial records for residents, and formally seeking the views of people that use the service and other stakeholders. What the care home could do better: Improvements are still required with the further individualisation of care plans, safe management of medication, the presentation and cleanliness of the environment, and staff supervision. Specific issues relating to the safety of the environment have been highlighted within this report. Key inspection report Care homes for adults (18-65 years) Name: Address: Shalom Home Shalom Home 143 Caistor Park Road Stratford London E15 3PR     The quality rating for this care home is:   one star adequate 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: Sarah Greaves     Date: 2 1 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 27 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 27 Information about the care home Name of care home: Address: Shalom Home Shalom Home 143 Caistor Park Road Stratford London E15 3PR 02084719533 02084719533 b.fadojutimi@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Bodi Fadojutimi Name of registered manager (if applicable) Mr Bodi Fadojutimi Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 3 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: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Shalom Home is a small care provider for 3 adults with a history of mental illness. It was registered in July 1999 and the registered provider is also the registered manager. The premises are located in a terraced house on a residential street in Stratford. The accommodation comprises of a communal lounge and attached kitchen diner, bathroom with wc and garden. There is a staff office/sleep in room and two Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 2 0 0 4 2 0 0 9 Brief description of the care home service user bedrooms located on the first floor, and a third service users bedroom located on the ground floor. There is a garden to the rear of the property and a large park nearby. The home has easy access to transport links and community facilities. Care Homes for Adults (18-65 years) Page 5 of 27 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted in one day by two inspectors. We gathered information through speaking to the one resident present, a member of the care staff and the registered manager. We looked at documents including two care plans, risk assessments, staff records (for training, supervision and recruitment information), and other policies and procedures. Information was also obtained through touring the premises and checking medication practices. This service waspreviously rated as being adequate at the previous inspection and has been rated as adequate at this inspection. Care Homes for Adults (18-65 years) Page 6 of 27 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. 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 27 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 27 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. Any prospective new residents would be provided with information about the care home including opportunities to visit and have a trial stay. Evidence: We viewed the Statement of Purpose and the Service Users Guide, which were found to be generally satisfactorily presented. There was an unusual claim in the Service Users Guide that staff functioned as counsellors and health educationers; the staff that we spoke to did not have the professional qualifications for either of these professions. There have been no new admissions to the service since the last inspection. The home accomodated up to three people and was at full occupancy. Past admissions had occured via appropriate assessments by the placing authorities. Care Homes for Adults (18-65 years) Page 9 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The planning and delivery of care to meet identified needs and wishes requires ongoing improvement. Evidence: Two of the residents personal files were sampled and in general they covered the personal, social and healthcare needs of the residents concerned. It was noted that there were improvements in relation to detailing the actions and support for residents around their mobility in the community, their finances and activities. One of the residents spoken to was aware of some of the detail in his care plan and the support arrangements in place for him, which he had signed up for. The care plans seen had been updated. Although the basis of the care plans came from a range of assessments, for example; cognitive, concentration, memory, mood, behaviour and depression, there was little evidence of how staff were guided to meet the mental health needs of the residents. We met one resident during the course of this inspection. Another resident was in Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: hospital and the remaining resident was on an overnight visit to relatives. The resident that we spoke to was very positive about their experience of living at the care home, stating that staff were supportive and encouraging, and responsive to identified support needs. Upon our arrival at the premises, a member of staff was on their way out to a local hospital to visit the hospitalised resident. There was no evidence of triggers for residents should they relapse, and indeed what action staff should take to minimise distress as a result of a resident failing to cope with the difficulties associated with their mental illness. From talking to the member of staff on duty it was not clear that they understood the specific problems associated with the mental health needs of the residents. Out of the assessments seen, actions for mood and memory were observed; for example for mood - staff to avoid arguements and for memory - staff to encourage the resident to write things down. This did not go far enough in appropriately supporting residents with mental health needs. In discussion with the registered manager, he confirmed that staff would not know what it means to be on the enhanced version of the Care Programme Approach (CPA) register. Care plans must include how the specialist mental health needs of residents are to be met. Slight improvements were noted with the risk assessments, including a risk assessment now being in place for a resident that had mobility problems. The risk assessments were more individualised and specific, although there was insufficient focus on mental health needs. There was a risk assessment for arson in place for one resident; however, there was no evidence of the person having committed arson or expressed any wish to do so. Care Homes for Adults (18-65 years) Page 11 of 27 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. Residents achieved suitable support to meet their social needs. The food service needs to demonstrate that healthy and nutritious food is being offered. Evidence: Activity plans were in place for the residents, including individuals that felt unable to participate in any form of activity. One of the care plans included shopping, going to the pub, playing snooker, reading, watching television, going to bingo and making new friends. It was positively noted that plans were being made to introduce a befriending arrangement. The files bore evidence that there is good contact with families, and there were plans in place for alternative community based activities to be explored for one resident who Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: did not wish to engage, until he felt he was ready to. One of the residents stated that the food service was good, including cooked breakfasts as requested; however, we noted an absence of fresh fruit (there were only apples) and fresh ingredients; for example, we found instant noodles, powdered mash and tins of soup. The menu plans were incomplete; the listing for a lunch was roast potatoes and vegetables (? meat or meat-free substitute) and on another day it was minced beef and mashed potatoes (? one or more vegetables). Supper was recorded as having been a take-away on two previous Wednesday evenings but no information was provided to demonstrate that a balanced meal had been promoted. The menu plan also stated that baked beans were served every morning for breakfast, which appeared repetitive unless this was a specific request from one or more of the residents. Staff informed us that this was a mistake on the menu plan, and this was confirmed through discussion with a resident. Care Homes for Adults (18-65 years) Page 13 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although some systems were in place for the provision of appropriate personal care and healthcare, the service needs to undertake considerable training and monitoring in order to ensure that medication practices are consistently safe. Evidence: Generally records indicated that residents health care needs are followed up; for example, diabetic care and ulcer care. Appropriate records were held in most cases for appointments with external professionals such as the GP, dentist, psychiatrist and chiropodist, however there were two cases in which the health care issues were not followed up by staff in the care home, relating to a retinal eye screen and a dietary referral. Although a risk assessment was in place for the medication of a resident for when he visited relatives but the arrangements were unclear as to how this would be safely managed. Via discussion with a resident we were informed that they were happy with the support given for personal care. The care plans that we read indicated that individualised care was identified to support people with their hygiene regimes, purchasing and laundering clothes, and other associated needs. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: The management of medication needed to be improved upon. The following observations were made: 1) A dispensing pot with prescribed medication for a resident that was in hospital had been left in the lounge. 2) The medication administration record for a prescribed medication (an anti-biotic) did not correspond with the prescribed amount. Twenty-eight tablets were prescribed yet the record sheet stated that the dosage had been given thirty-three times. 3) The medication administration charts did not record if a resident has a known allergy or not, which is deemed to be good practice. 4) Codes were used on the medication administration charts to indicate that a resident was in hospital or absent; however, the medication policy did not include the use of these codes. The medication policy needs to be updated to ensure that all staff are safely guided to consistently use an agreed code. 5) Out of date medicated cream found in a residents bedroom; it had expired in 01/05. It is acknowledged that the resident purchased or obtained this cream independently and may have been more recently acquired; however, the service needs to have a robust system in place to prevent residents from being at risk from using expired health care products. 6) A medication furosemide was written up by care staff as ferrousemide on the medication administration chart. We felt that evident spelling errors such as this could lead to confusion with medications that contain ferrous sulphate. 7) The service had introduced individual guides to accompany each medication administration chart, which provided information regarding each medication. It was recorded that bendroflumethiazide did not have any side effects; however, the British National Formulary stated that the side effects included gastro-intestinal disturbances and postural hypotension. Care Homes for Adults (18-65 years) Page 15 of 27 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 service would benefit from updating specific policies and providing on-going training; however, residents are assured that suitable measures are in place to protect individuals. Evidence: We looked at the services Safeguarding Adults Policy. The guidance was suitable although the telephone number for the local Safeguarding Adults department needed to be updated and references to the now non-existent public organisations such as the Commission for Social Care Inspection have to be removed. Staff had received Safeguarding Adults training from the local Safeguarding Adults team in Newham in 2008; we have advised that this training should be accessed from a reputable training provider every year or at least every other year. There have not been any recent Safeguarding concerns. An acceptable complaints procedure was available for residents and their supporters within the Service Users Guide. We found a policy regarding how to deal with complaints which was noted to be entirely unsuitable with bizarre statements such as most unsolicited criticism and general opinions can be taken with a grain of salt. The proprietor informed us that he did not know where the policy came from and it was destroyed during the inspection. There were no concerns in regard to how the service positively listened to and responded to any issues raised by residents. This was confirmed through discussion with a resident. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Care Homes for Adults (18-65 years) Page 17 of 27 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents need to be provided with a clean, comfortable and well-maintained environment. Evidence: The service occupies an ordinary domestic property in a residential street. The following observations were made during the inspection: The first bedroom that we viewed contained an empty plastic milk bottle. We were informed that the resident was using this item as a urinal, which we deemed to be entirely unsuitable in terms of promoting dignity and preventing cross-infection. Continence needs should be discussed with a relevant professional (GP, district nurse amd/or community continence advisor) so that appropriate equipment is used. Any refusal to use prescribed health care aids should be documented as part of a designated care plan. The proprietor stated that he ordinarily purchased urinal bottles from a chemist but there were none currently at the premises. The bedroom was dusty and the curtains in place were not adequate to ensure privacy. The sink was in a poor hygienic condition. We were informed that the resident did not permit staff to clean the bedroom; however, the state of the room placed the resident at risk of illhealth. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: Another bedroom had fourteen cardboard boxes (with essential medical supplies) and a travelcase full of incontinence pads. We were informed that community health services were conducting less frequent deliveries, which had lead to this situation. We were concerned that as well as making the bedroom appear clinical, the amount of cardboard might be considered a fire risk by a statutory fire officer. We have stipulated that the proprietor needs to take steps to address this issue. The shed in the garden did not have any glass in the window frames; we were able to reach in and pull out confidential information about the residents (archived documents from care plans). There was also paint and white spirit in the shed, which should be kept securely. There were broken paving stones in the garden, presenting a risk of trips and falls. The window frames for the bathroom were rotting and the paint was peeling off the walls. It was also noted that the radiator in the bathroom was corroding. A notice was displayed on the kitchen wall with confidential information (the names of any residents that were diabetic and what kind of appetites they have). There were also opened personal correspondence for residents sitting on a table in the lounge. Residents should be encouraged to keep their private mail in their bedrooms. The lounge appeared cluttered; for example, there were three screwdrivers sitting on a cabinet with a selection of board games. The environment appeared dusty; there were no offensive odours detected. Care Homes for Adults (18-65 years) Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents would benefit from receiving their care and support from staff in receipt of a better structured approach to identifying individual needs and areas for improvement. Evidence: We checked a randomly selected sample of staff files (four in total) in order to examine training, recruitment and supervision. It was noted that there had been a promising effort to support staff to undertake training such as National Vocational Qualifications at level 2, 3 and 4 depending upon the experience and aspirations of individuals. Mandatory training such as fire safety, food hygiene and first aid had been provided, and also training specific to the needs of people with mental health problems had been delivered. Staff had received training in medication practices; we were of the opinion that this training needs to be repeated, taking into account the issues of concern detected at this inspection. One member of staff was noted to have achieved a first aid certificate via electronic learning; we were informed that this would be followed up by a conventionally taught first aid course with practical assessments of competency. There were no issues of concern in regard to the safe recruitment of staff. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: We observed that although supervision appeared to be in place in the staff files, the supervision was brief. We would have anticipated that a service that recognised that it needed to improve would demonstrate a more in-depth approach to mentoring staff. Care Homes for Adults (18-65 years) Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although a limited degree of improvement has been attained, the service does not presently demonstrate robust management that will meet the holistic needs of the residents. Evidence: It was noted that certain improvements had been achieved since the last key inspection in terms of meeting some of the requirements and recommendations. There remains a clear need for further improvements. The service is owned and managed by the registered manager, who holds qualifications in management and mental health nursing. The service demonstrated that it had sought the views of residents and other external stakeholders through a satisfaction survey. The outcomes were generally positive. We noted the following areas for improvement in regard to health and safety practices: Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: The care home could not produce a Landlords Gas Safety certificate and the level of service from a gas company was not adequate for the premises. The electrical installations certificate could not be produced during the inspection and we have not been sent a copy as requested. Some items in the refrigerator were not adequately marked with the date of opening and date for disposal. On two occasions the date for the fire drill record had been altered. Alterations, if a member of staff has mistakenly entered the wrong date, need to be initialled. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 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 must ensure that the quality of the care planning (and risk assessments) are improved upon. To promote individualised care of a good quality for each resident. 30/09/2010 2 20 13 The registered manager 31/07/2010 must address the medication concerns identified in this report. To ensure the safety of the residents. 3 24 23 The registered manager must improve upon the cleanliness and comfort of the premises. For the safety and wellbeing of the residents. 30/09/2010 Care Homes for Adults (18-65 years) Page 25 of 27 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 4 42 13 The registered manager 31/07/2010 must address the health and safety issues identified in this report. For the safety of the residents. 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 17 The menu plans should accurately reflect the food provided to the residents. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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