Care Home: St James` Care Home (21)

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What the care home does well 21 St James provides a homely and safe environment for people to live in. The internal environment is comfortable and support is given to residents to personalise the home as they wish. People who use the service when possible make choices about their day to day life including meals, activities, outings and holidays. Staff reported that they endeavor to empower residents to do what they want to do. As a staff team they worked well together to provide a high standard of care and support to the people living in the home What has improved since the last inspection? The statement of purpose and service user guide had been updated. Storage of medication was found to be satisfactory. The kitchen floor had been replaced and repairs to the first floor bathroom required at the previous inspection had been addressed. On -going training with input from the local specialist community team is is provided on dealing with challenging behavior. All staff have attended Person Centered Planning training and the organisation is introducing a new care planning system which links in to person centered care. What the care home could do better: Staff with responsibility for carrying out supervision must undertake training in this area of their work. Evidence of current CRB checks must be available on all staff files. Staff involved in devising risk assessments should sign the assessment form Where records are updated forms should be signed and dated by the person carrying out the re-assessment. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St James` Care Home (21) 21 Old Hospital Close, St James`s Drive London SW12 8SS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Davina McLaverty     Date: 0 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: St James` Care Home (21) 21 Old Hospital Close, St James`s Drive London SW12 8SS 02086727149 Telephone number: Fax number: Email address: Provider web address: patricia.lewis@mst-online.org.uk Name of registered provider(s): Name of registered manager (if applicable) Patricia Sylvia Lewis Type of registration: Number of places registered: Metropolitan Support Trust care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 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: Learning disability - Code LD Date of last inspection Brief description of the care home St James (21) is a care home for five adults with a learning disability. The home is located in a residential road in Balham close to local shops and transport links. The home is run by Threshold Housing and Support. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good outcomes. The inspection included an unannounced visit to the service on the 4th November 2008. We met all five residents, the manager,and deputy manager and two support staff. We also looked at a number of records, which included three resident’s files, staff files, care plans, health and safety records as well as the environment. In addition, the inspection took account of information received about the service since it last inspection. Care Homes for Adults (18-65 years) Page 5 of 28 We asked the manager to complete an Annual Quality Assurance Assessment (AQAA), which is a self assessment of the service and is also referred to in the report and helped us to form some of the judgments made. Communication with the majority of residents was not possible due to the level of their learning disability. One resident said that they liked it at the home and that the staff were nice. One survey received from a relative who had completed it on his relatives behalf was very positive about their relatives care, the home and staff team. Residents were observed to be very much at home on return from their day activities and were at ease with the staff who supported them What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has good written information that would enable potential residents and their advocates to make a choice about whether they would like to move to the home. No new resident would be admitted without a through assessment to ensure that the home can adequately meet their needs. Evidence: There is a statement of purpose and service user guide that describes what new residents can expect from living at 21 St James and the aims of the service. Since the last inspection one new resident has moved in to the home. Evidence of the care managers assessment was seen, as well as the care homes own assessment. Due to the needs of this resident, professionals agreed that visits to the home would not take place instead the person was shown pictures of their new room and the other people who live in the home. Existing residents have lived in the home for many years and the manager and staff demonstrated detailed knowledge about their lives and their needs. The AQAA states that Annual reviews are held to assess service users Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: changing needs together with network meetings as and when required. Evidence of these meetings were seen on the files examined. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to health care services both within the home and in the local community. Care plans are in place and kept under regular review. The care planning system is person centered and aims to ensure that individual needs are being met. Risk assessments are in place and kept up to date, ensuring that people are protected. Evidence: Three residents files were looked at. We saw information covering assessments of what people can do and the areas they need support and assistance from staff. Person centered plans have been developed which includes some long and short term goals people want to achieve. Residents are involved in devising their support plan as much as they can be given their needs. We saw that reviews were taking place on a regular( six monthly ) basis with all people involved in an individuals care invited to discuss progress and changes in need. However, where care plans are updated and significant changes have occurred new Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: plans must be written to ensure that all staff are clear as to the current care plan being used. Also all documents currently being used must be in the organisations name. One of the care plans examined the guidelines being used where those of the previous placement. This could cause confusion. The home operates a key work system, which allows staff to work on an individual basis with people who use the service. This supports the development of person centered plans, and provides time for people to achieve their goals. One person spoken with confirmed that they meet with their key worker and do things they want to do eg go out. Monthly reports of key workers meetings were seen on all three files. Residents are supported to participate in the community on a regular basis. Risk assessments were seen on the files looked at and included general risk assessments eg fire safety, hot water,whether the person should have their own keys as well as individual risk assessments dependent on the persons individual needs and what they would like to do. Risk assessments were seen to be updated but the inspector recommends that all parties involved in drafting the risk assessment sign the final document and where risk assessments change significantly a new document is drafted. This principle should also apply to support plans. The AQAA states that the home plans over the next twelve months to produce support plans and risk assessments in a more appropriate format for service users. The home also wants to develope its communication systems to enable more resident involvement in all aspects of the running of the service, as well as to work with Wandsworth advocacy partners to promote residents independence. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are involved in meaningful daytime activities of their choice, to meet their individual needs, ability and interests. The service has a strong commitment to enabling people who use the service to maintain and develope social, emotion, communication and daily living skills. Contact with friends and family is encouraged and staff continue to encourage and support residents to be as independent as possible. Evidence: Residents are involved in a variety of day time activities, Some attend social education centers whereas others receive one to one support and are supported to undertake activities in the local community e.g. going to the cinema, swimming etc. One resident currently does not want to go to a day center or participate in activities. This person stays at home with staff supporting them. In discussion with the manager she stated Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: that due to the needs of this person the home is currently looking at one to one support for them during the week as the person can be very challenging, although on some days they would want to participate in an activity which is why regular one to one support is being discussed. Activities in the evening varies depending on individual needs and moods. A large flat screen television is available in the lounge, as well as music equipment. Some residents have their own televisions and CD players in their rooms and will choose to spend time on their own. One resident enjoys making his own music and has various musical equipment in their room eg hand held drums, shakers etc. Residents make full use of the local transport system with staff support and regularly go out to the pub, bowling, parties and discos, as well as shopping for the house and for themselves. This was seen to take place on the day of the inspection when a resident was accompanied out by the manager to buy an household item. We saw that relatives and friends are welcome to visit and people who use the service are supported by staff to maintain important family relationships. A relative in the survey said my relative has blossomed since moving here. He is extremely well looked after and is very happy and now more alert. He adores his carers, who have been absolutely brilliant in his welfare. We were told that one residents family takes their relative to church with them weekly, another receives regular visits from family at the home. The home also involves family members as much as the resident and relative want in their support package. Due to the needs of two residents involvement with cooking is limited. The other three residents however, are involved in shopping and meal preparation if they wish, as well as setting the table and bringing their plates to the sink. One resident spoken with said that they liked going shopping for the weeks food but does not the cooking. Another resident has cooking sessions with their 1 to 1 worker and will prepare meals from his home country.eg jeloff rice, plantain etc. The menu seen is varied and takes into account peoples dietary and medical needs. Throughout the day, staff were observed to treat residents with respect and were very patient. From discussion with staff they said that although residents are unable to communicate verbally they are very aware of their needs, either through the sounds/gestures residents made. This was seen to be the case with residents responding to staff comments. Care Homes for Adults (18-65 years) Page 14 of 28 Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal and health care support using a person centered approach with support based on dignity, equality and respect. Staff support people who use the service to attend health care appointments and document any issues, concerns or actions. An appropriate system is in place for the safe administration of medication. Evidence: As previously stated the majority of residents are non verbal or find it difficult to discuss their needs in detail. Staff through their experience and length of time working with the residents have identified their needs through their body gestures and sounds made. In discussion with staff they stated that personal care is carried out in a sensitive way to maximise the persons privacy, dignity and independence. Everyone is encouraged to do as much as they can for themselves. The AQAA states that the home would like to employ more male staff to support more male service users with personal care. All residents in the home are male. Daily records are kept on each resident, and these were seen to be of a good standard Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: and give a clear picture of each persons day. Guidelines on how to support residents are also available. The AQAA states that all residents are registered with a good GP who understands the needs of the person. Evidence was seen on the files examined of contact with the GP and other health care professionals eg opticians, dentist as well as specialist support as and when needed eg speech and language specialists, occupational therapists and psychologists. Service users all have an annual health check and a health action plan was seen on the files looked at. Residents continue to be protected from harm by clear guidance and procedures that are in place for medications. Medication records examined had no gaps in the recording of administration of medicines. Medicine reviews are evidenced as being carried out. Each medication record had a current photograph of the resident and details of any allergies. There were clear instructions for when PRN medications were to be given and information leaflets on the medications that tenants have been prescribed. Medication reviews take place at least annually for all residents. Medication that currently requires cold storage is kept in a locked container in the fridge. The manager stated that a small lockable fridge has been ordered to store medication which must be kept in the fridge. Evidence of staff training on administering medication was seen. The AQAA states that the home plans over the next twelve months to look at where we can engage service users in expressing their wishes in the areas of aging, death an illness. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Organisational policies and procedures are in place to protect residents from abuse as well as to support residents who are not happy and wish to make a complaint. Evidence: The manager stated that there had been no formal complaints received since the last inspection. The Commission for Social Care had also not received any concerns about the service. Staff are mindful of residents methods of communication and stated that they can usually tell from the gestures used if someone is not happy. Complaints are now an agenda item on the monthly key working meetings with residents. The records of these sessions was seen. Details on how to make a complaint is on the homes notice board although in view of the level of residents learning disability it is not clear whether residents would understand what to do if they were not happy. Policies and procedure are in place for the protection of vulnerable adults. A copy of the local authority procedure is available in the home. Two staff spoken to confirmed that they have completed training in safeguarding vulnerable adults and are aware of their responsibilities. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was found to be clean on the day of the inspection, although some areas require decorating to maintain its homeliness. Specialist aids and equipment are available to meet individual needs. Bedrooms are single and have been personalised to individual taste and choice. Evidence: The premises are homely in appearance and blend into the environment and is not easily identifiable as a care home. However, in discussion with staff due to the homes location on a housing estate the local community are very aware that no 21 is a care home and the young children and some youths on the estate can be a problem targeting residents when out. Staff have involved the police to talk to the young people who tend to congregate under the homes car port. The manager also have tried to address this with the local youths. The home was seen to be well maintained and is homely in appearance. The manager reported that the communal areas are due to be decorated over the next year. All five bedrooms were seen and each one was personalised and reflected the residents personality and needs. Furniture is a of good quality, and rResidents are encouraged to Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: see the home as their own. One bedroom is wheelchair accessible with en suite facilities. There is a large kitchen/dining room as well as a good size lounge with appropriate furnishings. Staff have adequate sleep in accommodation. A separate laundry room is available on the ground floor, as well as a separate toilet. Bathrooms are fitted with appropriate aids and adaptations to meet the needs of the people who use the service. The garden is also a good size and staff are encouraging one resident in particular to be more active in the garden and have some responsibility to keeping it nice. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are appointed following an appropriate recruitment and selection procedure. Staff have access to training appropriate to their roles. The staff team support each other and share skills and knowledge to provide a good service to people. Staff roles and responsibilities are clearly defined. Good recruitment practices are in place, although not all checks were seen to be on the files. Staff have access to a range of different training to meet individuals needs. All staff receive regular supervision. Evidence: Two members of staff are on duty during the day, with the manager in addition on some weekdays. At night there is one member of staff awake and one member of staff asleep but on call. These staff levels were seen to be sufficient to meet peoples needs. We saw good interactions between people who use the service and staff. Staff demonstrated a good knowledge and understanding of individual needs. We saw people who use the service to be comfortable and relaxed with staff. We saw good policies and practice for recruiting staff, however two of the four files examined did not have a current Criminal Bureau checks on them, potentially placing residents at some risk. Two members of staff spoken with, spoke positively of the organisations induction stating that it covered everything that they needed to know Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: very well. The home currently has one vacancy which we were told had been recruited to. The home was waiting for all checks to come in before the person starts. Staff have access to regular training relevant to their role. Staff spoken to were all very positive about the training and felt that the organisation saw training as a priority. Staff spoken with confirmed that they received regular supervision and evidence of this was seen in the files examined. Good systems are in place with dates being identified for supervision for individuals throughout the year. Following supervision bot parties sign to confirm that it had taken place. However, where staff give supervision they must be given training in this area of their work. This was found not to be the case. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the experience to run the home. The manager and staff operate in a person centered way. A quality assurance system is in place. Systems are in place to monitor the health and safety of residents and staff. Evidence: The manager is registered to manage this home and another home in close proximity . The manager stated that shehas NVQ level4 and hopes to complete the Registered Managers Award soon. The manager leads and supports a strong staff team who have been recruited and trained to a high standard. The AQAA contains clear, relevant information that is supported by a wide range of evidence . The AQAA lets us know about changes they have made and where they still need to make improvements. Staff were extremely positive about the manager and her management style which was described as very hands on and supported. They also described her as a very hard worker who wanted to provide a very high standard of care and support to the residents. As a result of this morale in the home was high and people worked hard. An Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: agency staff on duty also confirmed this and said that they really enjoyed coming to work in this home. Residents meetings take place but due to the level of communication, one to one key working sessions are seen as more effective in seeking peoples views. One resident spoken to said that they were given opportunities to raise any concerns as well as asked their opinions about the service. We saw records of monthly staff meetings, in which staff are given the opportunity to discuss practice issues and to discuss residents needs given information about training, updated on changes to people who use the service and changes within the oganisation as well as providing a forum where they can discuss issues which they deem to be important. Copies of monthly regulation 26 visits were seen in the home. The manager stated that a quality assurance system is in place, which seeks the views of residents, relatives and other stakeholders. Questionnaires are sent out annually on return, collated and necessary changes made. The outcome of the quality assurance system used should be available in the home. We saw evidence of good health and safety policies, practices and records of weekly fire alarm tests, water checks, landlords gas safety records and portable appliance tests. COSHH assessments were in place. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Where care plans are updated ,that any change is clearly recorded and visible. To ensure that all staff are fully aware of the current care plan in use with the resident. 23/01/2009 2 34 19 A current CRB check must 12/12/2008 be available on all staff files. To ensure the safety of residents 3 36 18 Any staff who provides training must receive training in this area of their work To ensure that staff carrying out supervision have the necessary skills. 06/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 28 1 9 Risk assessments should be signed by all parties involved in drafting them. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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