Care Home: The Conifers

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What the care home does well People told us that they were happy living at the Conifers. One person told us in a survey, "It is my home. I have many friends." The service user guide contains pictures to make it easier for people with learning disabilities to access the information. Each person who lives at the home has been given a copy of the complaints procedure which has been written in a way to make it easier for people with learning disabilities to understand. Care plans include details of people`s spiritual needs and records show that people attend places of worship if they wish to. The home is developing person centered plans for people. The person centered plan seen for one of the people we case tracked contained detailed information about how staff should support the person to meet their needs, preferences and aspirations. People told us that they were involved in the running of the home, having weekly house meetings and contributing to the day to day chores and household tasks. What has improved since the last inspection? The home has a developed a folder that contains clear guidance for staff on their responsibilities to safeguard people from harm. A new format has recently been devised for surveys to make them more accessible for people with a learning disability. A spot check of people`s money showed that all money held by the home on behalf of the people who live there is accounted for appropriately. There was evidence that the recording systems used within the home were in the process of being updated to make them more accessible and comprehensive. The complaints procedure has been updated to include timescales. What the care home could do better: The Statement of Purpose did not include details of the categories of people that the home is registered to take. People`s contracts had not all been signed and did not detail their current fees. Care plans did not consistently detail people`s preferences or how staff should support them to meet their goals and aspirations. The majority of care plans seen had not been updated recently with "no change" being documented each time the care plan is reviewed. Assessments of the risks to individuals were not consistently updated to show how staff need to support people to be safe without imposing unnecessary restrictions. Some staff had not signed to show that medication had been given. There was no clear audit trail to show the total amount of one `controlled drug`. Not all of the required pre recruitment checks had been completed and recorded prior to one staff member starting work at the home. None of the radiators in the home have radiator covers and there was no evidence of the risk to people being assessed if they were to fall against a hot radiator. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Conifers 1a Lodge Road Rushden Northants NN10 9HA     The quality rating for this care home is:   one star adequate 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: Catherine Perrins     Date: 1 0 0 8 2 0 0 9 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. 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. 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: The Conifers 1a Lodge Road Rushden Northants NN10 9HA 01933395522 01933395511 claudiacarine@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Marie Jeanette Judith MatherFranks care home 12 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: All service users have a Learning Disability No service users with a physical disability may be admitted to the home when there are already 4 such service users within the home The total number of service users must not exceed 12 Date of last inspection Brief description of the care home The Conifers is a care home which provides personal care and support to 12 people with learning disabilities. It is one of three homes in Rushden, owned by Mrs Mather Franks. The home was first registered by the local authority in 1990 and is a two-storey detached house. There are six single and three shared bedrooms. There are bathing Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 12 4 Brief description of the care home facilities on both floors and a range of communal areas. All areas of the ground floor and garden are accessible to people who use wheelchairs. The home is situated in a quiet residential area of Rushden with access to local facilities and amenities. Fees at the time of inspection were 300 to 830 pounds per week. Additional costs paid by service users include hairdressing, chiropody and some travel such as individual taxis. Care Homes for Adults (18-65 years) Page 5 of 29 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: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This was an unannounced key inspection which means that we focused on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of three hours was spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for, since the last key inspection. This included: Care Homes for Adults (18-65 years) Page 6 of 29 Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. The inspection visit lasted six hours. The majority of the inspection was done on the first day but as the registered manager was not present that day we returned a second time to access staff files as staff do not have access to these when the manager is not present. Both visits occurred on weekdays. During the inspection three people were case tracked. This involves looking in detail at all aspects of their care and experiences at the Conifers, including looking as their individual plans of care and other records, talking to them and talking to their care staff. Because people with learning disabilities are not always able to tell us about their experiences we also used observations of peoples state of well being and how they interacted with staff members and others. What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose did not include details of the categories of people that the home is registered to take. Peoples contracts had not all been signed and did not detail their current fees. Care plans did not consistently detail peoples preferences or how staff should support them to meet their goals and aspirations. The majority of care plans seen had not been updated recently with no change being documented each time the care plan is reviewed. Assessments of the risks to individuals were not consistently updated to show how staff Care Homes for Adults (18-65 years) Page 8 of 29 need to support people to be safe without imposing unnecessary restrictions. Some staff had not signed to show that medication had been given. There was no clear audit trail to show the total amount of one controlled drug. Not all of the required pre recruitment checks had been completed and recorded prior to one staff member starting work at the home. None of the radiators in the home have radiator covers and there was no evidence of the risk to people being assessed if they were to fall against a hot radiator. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 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 29 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. People generally receive good information about the home before they move in but some of the information needs to be updated. Evidence: The home has a statement of purpose and service user guide, both generally give people good information about the home and the services it offers. They do not, however, include information about the categories of people that the home is registered to take. The statement of purpose also indicates that some of the bedrooms are en suite which is not the case. The service user guide contains pictures to make it easier for people with learning disabilities to access the information. Records show that peoples needs are assessed before they move to the Conifers to make sure that the home is right for them. Staff explained that people are able to visit the home before they move in to have a look around and meet the other people who live there. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: Records show that people are given a contract when they move to the home which details the terms and conditions of their placement. Not everyone had signed their contracts. One persons contract was dated 2003 with no evidence of it being updated to show their current fees or to reflect any other changes. Care Homes for Adults (18-65 years) Page 12 of 29 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. Records do not consistently detail peoples individual needs and choices but the home is taking steps to improve how peoples needs are assessed and documented. Evidence: Each person who lives at the home has an individual plan of care. This contains their care plans and other information that staff need to care for people in the right way. Care plans seen covered areas such as communication, eating and drinking, personal care, mobility, culture and religion, health and continence. They contained some detail about peoples preferences such as what time they liked to get up and go to bed, but did not consistently detail how peoples needs and preferences should be met. For example it was recorded that one persons goal was to enjoy relaxation more. Her care plan stated that she liked to relax by sitting down to watch the television or a film. It did not state which programmes or types of films she liked or whether she liked to watch them on her own in her room or in the lounge with others. Another persons goal was to wash himself in the shower but his care plan did not state what staff Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: should do to support him to achieve this. Care plans included details of peoples spiritual needs and records show that people attend places of worship if they wish to. The majority of care plans seen had not been updated recently with no change being documented each time the care plans are reviewed. One persons care plans had not been updated since August 2007 indicating that no progress had been made towards achieving his goals. Staff explained that the home is currently in the process of developing person centered plans for each of the people who live at the home. A person centered plan is similar to a care plan but is more specific and personal to the individual. One of the people we case tracked had a person centered plan which was nearing completion. It contained detailed information about the persons needs and preferences and clear information for staff about how to support the person in the right way. For example it gave a lot of information about how the person communicates and what staff should do to be able to communicate with the person effectively. Peoples individual plans of care also contained assessments of any risks that they may face in their day to day lives and steps taken to avoid any unnecessary risks. The care plan for one person stated that they were at risk of choking and should have their food liquidized to minimise this risk. Their eating and drinking risk assessment did not however, mention the need to liquidize food. It is important that assessments of risk are up to date to ensure that people are not subject to either unnecessary restrictions or to avoidable risks. People explained that they were involved in the running of the home. One person told us that she had dried up the breakfast dishes. Another person said that he helped with the cooking and food shopping. Records show that house meetings are held each week so that people can plan the menus and activities and discuss any other matters to do with the home. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the Conifers enjoy active lives. Evidence: People told us that they were happy living at the Conifers. One person told us in a survey, It is my home. I have many friends. People told us that they enjoy visits from their families. People told us about various activities that they had enjoyed including swimming, bowling and a recent boat trip. All of the people who live at the Conifers attend various day centres, with some people attending five days per week. One person showed us some holiday photographs of a holiday she had enjoyed in Tunisia which were displayed on the lounge wall. Staff explained that people go on holiday every year supported by staff. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: People told us that the food was good and that they helped to plan and prepare meals. Care Homes for Adults (18-65 years) Page 16 of 29 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. Peoples personal and health care needs are generally well met but recording of their medication is not consistently robust. Evidence: Records show that people attend health appointments such as general practitioner, psychiatrist, dentist, optician and podiatrist as required. People also see occupational, physio and speech and language therapists if they need to. Records show that medication is generally given as prescribed however there were some signatures missing from the medication administration record for people who require the administration of prescribed creams. This suggests that these creams may not have been applied as directed by the prescribing doctor or nurse. The instructions for some creams were also not clear stating apply as directed without giving details about how and where the cream should be applied. The home has appropriate storage for controlled drugs however records were not clear about the total amount of a controlled drug that had been prescribed for one person as the total amount of medication had not been carried forward from previous months Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: recording sheets. Controlled drugs are prescribed medicines which some people abuse them by taking them when they have not been prescribed, there are laws and regulations about how these drugs should be stored and administered. Care Homes for Adults (18-65 years) Page 18 of 29 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. People are supported to raise any concerns that they may have about the home. Evidence: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. Each person who lives at the home has been given a copy of the complaints procedure that contains pictures and has been written in a way to make it easier for people with learning disabilities to understand. The manager said that the home has not received any complaints since the last inspection. The home has a folder that contains clear guidance for staff on their responsibilities to safeguard people from harm. Staff spoken to were aware of how to raise any concerns that they may have. Some issues relating to keeping people safe have been mentioned in other sections of this report. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a homely living environment with spacious communal areas. Evidence: The Conifers is a large detached property. It has six single bedrooms and three double bedrooms. The shared bedrooms have a curtain to divide the room and give people some privacy. Bedrooms had been made personal with pictures, photographs and personal effects. The home has two lounges each of which has a dining area. There is also a conservatory which is used as to sort and store laundry before it is taken to peoples rooms to be put away. The lounge and dining areas had pictures and ornaments to make them feel homely. The property is adequately furnished and decorated although there are some signs of wear and tear such as damage to the wall paper and rips to the dining chair covers. There is a wet room downstairs and a bathroom and separate shower room upstairs. Water in the upstairs bath was noted to exceed 43 degrees Celsius which puts people at risk of being scalded. Staff explained that no-one currently uses the bath as they prefer to shower. When the potential risk was brought to the attention of staff they Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: removed the plug from the bath and put a sign on the bathroom door to warn people that the water was very hot. Staff then contacted a plumber and arranged for the hot water temperature to be regulated at a safe level within a week of the inspection. The lock on the linen cupboard was observed to be broken causing a potential fire risk. This was brought to the attention of the staff who arranged to have a new lock fitted later on the day of inspection. There is a small courtyard at the rear of the property which has a swing seat for people to sit in when the weather is good. There is a small laundry area in a lean-to extension in the courtyard. It does not have any facility to sluice soiled clothes so this is done using the outside tap prior to washing in the washing machine. Care Homes for Adults (18-65 years) Page 21 of 29 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. People are supported by adequate numbers of staff who have been suitably trained but recruitment checks are not consistently robust. Evidence: The recruitment of new staff is generally well managed. The references for one staff member however, did not include a reference from their last employer and their application form showed a gap in their employment history with no evidence of an explanation having been sought to explain what the staff member was doing during this time. Thorough pre employment checks are important to ensure that staff are suitable to work with people with learning disabilities. Information regarding peoples pre employment checks were made available during the inspection and advice was given to the registered manager about what information needs to be kept with regard to peoples clearance by the Criminal Records Bureau. (CRB) Staff told us that they had an induction when they first started working at the home which included working alongside an experienced colleague to make sure that they had all of the information that they need to do their job in the right way. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Staff explained that they attend training courses such as food hygiene, safeguarding of adults, dementia care, infection control, fire safety and moving and handling. Care Homes for Adults (18-65 years) Page 23 of 29 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. Management systems within the home are improving but some current shortfalls put people at risk. Evidence: Satisfaction surveys were seen on the files of the people we case tracked. These showed a good level of satisfaction. Staff explained that a new format has recently been devised for surveys to make them more accessible for people with a learning disability. These new surveys had not yet been distributed to the people living at the home but we were told that this was due to happen in the near future. Records show that the necessary safety checks such as fire checks, checks on the water system and portable appliance testing have all been carried out recently. None of the radiators in the home have radiator covers and there was no evidence of the risk to people being assessed if they were to fall against a hot radiator. A health and safety audit is carried out on a two weekly basis by the registered Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: manager or senior carers. An improvement plan dated June 2009 was viewed which highlighted some work which needed doing as a high priority, this work had not been completed at the time of inspection although staff did indicate that some steps had been taken to address issues raised. The home have devised a swine flu plan which gives staff information about swine flu and details how the home will respond should any staff or people living at the home become unwell. A spot check of peoples money showed that all money held by the home on behalf of the people who live there is accounted for appropriately. There was evidence that some improvements had been made in the areas outlined in the requirements and recommendations made following our last key inspection however some areas were noted to be still outstanding. There was evidence that the recording systems used within the home were in the process of being updated to make them more accessible and comprehensive. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 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 20 13 Records pertaining to 31/08/2009 peoples medication must be accurate and provide a clear audit trail of medication received into the home and administered. The total amount of all medication held by the home must be clear and legislation and guidance regarding the administration and recording of controlled drugs must be adhered to. To ensure that people receive their medication as prescribed. 2 34 18 All pre recruitment checks must be completed and recorded prior to staff starting work at the home. To ensure that all staff employed at the home are suitable to work with people with learning disabilities. 31/08/2009 Care Homes for Adults (18-65 years) Page 27 of 29 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 3 42 13 Measures must be put in place to ensure that the home is safe and free from unnecessary risks. To ensure the health and safety of all. 30/10/2009 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 1 2 1 5 The Statement of Purpose should include details of the categories of people that the home is registered to take. People should have a written contract outlining the terms and conditions of their stay at the home and details of their current fees. Individual plans of care should give information about peoples needs and preferences and detail how these are to be met. Individual plans of care should detail how people are to be supported to meet their goals and aspirations. Individual plans of care should be reveiwed reguarly and any change in peoples needs documented. Assessments should be undertaken and necessary measures put in place to ensure that no-one is at risk from being burnt by a hot radiator. 3 6 4 5 6 6 6 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!