Care Home: The Mount

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What the care home does well Staff support people to do the cleaning, cook their meals and do their washing, so they can be as independent as possibleThe people living in the home are supported to keep in contact with their families and friends so that they do not lose relationships with people that are important to them. People living in the home and their families are involved in their care plans, so they are supported in the way that they want to be. Staff support people to go to places that they want to go to and to do the things they want to do.If people want to go on holiday they are supported to go, but if they prefer they can go on day trips instead. What has improved since the last inspection? Medicines are being looked after properly.Staff are now having supervision more often, so they now what they have to do and how to do this properly.There are more things for people living in the home to do. What the care home could do better: One care plan did not tell us enough about how the person needs help to do things.The bay windows at the front of the building do not close properly and need to be fixed.One staff need to do more training, so they can do their job properly.The manager needs some more time to do the work in the office. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Mount 29 Palmer Lane Barrow On Humber North Lincolnshire DN19 7BS 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: Wilma Crawford Date: 2 2 0 4 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 31 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 31 Information about the care home Name of care home: Address: The Mount 29 Palmer Lane Barrow On Humber North Lincolnshire DN19 7BS 01469532897 01469532897 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Prime Life Ltd care home 19 Number of places (if applicable): Under 65 Over 65 19 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Learning disability Code LD The maximum number of service users who can be accommodated is: 19 Date of last inspection 2 2 0 4 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home The Mount in Barrow on Humber, owned by Prime Life Ltd, provides personal care for adults with a learning disability. There is a house and two bungalows. The rooms are for one person, except for one in the main house which is for two people. All of the houses have a garden. One of the bungalows can be used by people who need to use a wheelchair. On April 22nd 2009 the manager provided information that the home charges from 349.57 pounds to 359.19 pounds per week, for which care and accommodation are provided. These fees are based on a standard fee and an additional package of hours based Care Homes for Adults (18-65 years) Page 5 of 31 on the individuals needs. Care Homes for Adults (18-65 years) Page 6 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 31 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means that people living in the home experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations- but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the registration of the home and includes information gathered during a site visit to the home. The site visit was unannounced and took place Care Homes for Adults (18-65 years) Page 8 of 31 over seven hours. We spoke to seven people who were living in the home. The inspector looked at some care plans and some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We spoke to staff and the manager. What the care home does well Staff support people to do the cleaning, cook their meals and do their washing, so they can be as independent as possible Care Homes for Adults (18-65 years) Page 9 of 31 The people living in the home are supported to keep in contact with their families and friends so that they do not lose relationships with people that are important to them. People living in the home and their families are involved in their care plans, so they are supported in the way that they want to be. Staff support people to go to places that they want to go to and to do the things they want to do. If people want to go on holiday they are supported to go, but if they prefer they can go on day trips instead. Care Homes for Adults (18-65 years) Page 10 of 31 What has got better from the last inspection Medicines are being looked after properly. Staff are now having supervision more often, so they now what they have to do and how to do this properly. Care Homes for Adults (18-65 years) Page 11 of 31 There are more things for people living in the home to do. What the care home could do better One care plan did not tell us enough about how the person needs help to do things. The bay windows at the front of the building do not close properly and need to be fixed. Care Homes for Adults (18-65 years) Page 12 of 31 One staff need to do more training, so they can do their job properly. The manager needs some more time to do the work in the office. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Wilma Crawford Care Quality Commission St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB Care Homes for Adults (18-65 years) Page 13 of 31 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 14 of 31 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 15 of 31 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 who use the service experience good quality outcomes in this area. People have their needs assessed prior to moving into the home, so they are confident they will be met and they are given enough information about the home and its facilities before they make a decision to live there. The judgement has been made using available evidence including a visit to the service. Evidence: The home has an up to date statement of Purpose and a Service User Guide that describes what services are provided by the home. The Service user guide is also available in a pictorial format .Individual terms and conditions are available for each person living in the home and includes details of which room is to be occupied. Four case files were examined and found to include a full assessment of the individual, which had been undertaken before moving into the home. Community care plans were used alongside the assessment to develop individual care plans. A discussion with the manager, staff and people living in the home, supported the admissions process described by the manager and the information submitted in the Aqaa document. People are given the opportunity to visit the home, have a meal or an overnight stay before making a decision to move in. Care Homes for Adults (18-65 years) Page 16 of 31 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 who use the service experience good quality outcomes in this area. People living in the home have their individual needs met and are involved in some aspects of decision making to promote their independence. This decision has been made using available evidence including a visit to the service. Evidence: Each individual care plan examined described how individuals assessed needs are met and was signed by the individual or their representative. Four care plans were seen as part of the care planning process and were found to demonstrate how peoples’ needs were identified and met. Care plans are evaluated on a monthly basis and updated if this is required. Annual reviews also take place, these can be undertaken sooner if the need arises. Records of reviews show that the individual is asked what they would like to discuss at their review meeting, shows who has been invited, who attends and what action is to be taken as a result of the meeting. Risk assessments were found to be detailed and covered a range of areas of risk in daily living, supporting people with the opportunity to go out, whilst reducing the risks involved in this. However one individual, did not have detailed information around how Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: they should be supported by staff to maintain their dignity in certain situations. When staff were spoken to they had a clear understanding of how the individual should be supported during these situations. A recommendation was made in respect of this. People spoken with were aware of their care plans and the content of these. Some individuals were able to give examples of how their independence had been promoted, for example being able to go to the local shop independently. The people living in the bungalows are more independent and are working towards living more independently in the future. These individuals are supported by separate staffing according to their individual needs. As part of promoting their independence and working towards developing new skills, they are supported and encouraged to be actively involved in decision making about their daily routines and activities, including shopping, food preparation, domestic tasks as well as their own preferred activities and hobbies. Staff spoken with found the care plans to be comprehensive and informative and had a good understanding of individual needs. People living in the home were also able to give examples of being involved in meetings to seek their views and opinions, including menus, outings, activities, trips, decoration of the home and reviews. One person gave an example of suggesting jugs of juice being available in the dining area at all times as well, which was implemented and seen on the day of the visit. Staff spoken with were also able to describe the consultation process and minutes of these meetings were available within the home. Care Homes for Adults (18-65 years) Page 18 of 31 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 who use the service experience good quality outcomes in this area. People using the service have opportunities to access a choice of leisure activities and are supoorted to maintain relationships. Evidence: During the last year the home has put a lot of effort has gone into planning and developing a range of activities for the people living in the home. These include community based activities such as the Knotted Note Centre where people engage in a range of activities every Monday over a seventeen week period. People who were accessing this activity said that they were thoroughly enjoying this and looking forward to the different themes each week for example, animal week, food week and safety week. A variety of other activities available include a relaxation group, visiting beauty therapist and hairdresser, bingo, arts and crafts, gardening and caring for the animals. Other community based activities included helping in the village hall, attending church,a local day centre, shopping , outings, daytrips, visits to local garden centres Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: and places of interest. The home has its own minibus for transport.A monthly charge is made to all people living in the home using the transport and they or their representative sign an agreement to that effect. A pictorial and written record is maintained of all the trips and events held. On the day of the visit a variety of activities were taking place, some people went out shopping, others were involved in caring for the animals, some were watching television or listening to music, whilst others were engaged in domestic activities or helping with preparations to celebrate a birthday. The range of activities has been developed in consultation with the people in the home in order to provide a range of suitable age appropriate activities for the people living in the home. Minutes of residents meetings and discussion with people living in the home and staff further supported the consultation process. People also have the opportunity to go on holiday and the home regularly hold fund raising events, hold barbeques which relatives attend. People also said that their visitors could come at any time and were made welcome by the staff. One individual gave an example of being supported to travel home to visit their family on a regular basis. Discussion with the manager, coo, people living in the home and examination of the menu, demonstrated tat a full and varied diet is available in the home. This has been planned in consultation with the dietician and people living in the home, based on their individual likes and dislikes. People living in the home gave examples of choices available and said that staff always asked them what they would like to eat. They also said that they enjoyed the food and that it was good. One person described how they celebrated their birthday in a manner of their choosing and gave additional examples of how their peers preferred to celebrate theirs in different ways. The celebration of other events was also described including, Christmas, barbeques, halloween, easter and Christmas. Information in care plans showed that weights are checked on a monthly basis and nutritional assessments are completed to support individuals dietary needs being met. The lunch time meal was observed and found to be a calm, sociable occassion, with staff supporting people in a patient and dignified manner. People living in the bungalows have their own food budgets and are responsible for planning their own menus. Care Homes for Adults (18-65 years) Page 20 of 31 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 who use the service experience good quality outcomes in this area. People living in the home recieve appropriate assistance and support to maintain their personal and healthcare needs. medication is stored appropriately and records are well maintained. This judgement has been made using available evidence and including a visit to the service. Evidence: Information in care plans showed that people living in the home have their preferred routines and discussion with staff demonstrated that they have a good understanding of the wishes and choices made by each individual, describing their care needs and and how they recognised when help was needed, while respecting peoples wishes and supporting them to maintain their independence skills as much as possible. at the previous inspection a requirement was made that stock levels of controlled medicines b maintained. This has been put into place. The running total of stock levels was found to have been completed and accurately reflected the stock levels within the home. Examination of medication sheets were found to be completed, up to date and well managed. The home uses the Boots Monitored Dosage system and a locked trolley and locked cupboard are used for the storage of medicines. All staff who have Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: responsibility for the administration of medication, have received training. An independent audit of the home and systems is completed by an independent pharmacist, the most recent report showed satisfaction with the homes management of medication. Care Homes for Adults (18-65 years) Page 22 of 31 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 living in the home were able to describe how they could use the complaints process and were confident that they could talk to any of the staff if they had any problems. Some people living in the home are unable to use the complaints process independently, the manager and staff during discussion explained that they have information of local advocacy services which could be used to support these individuals or their families. One complaint has been received by the home during the last twelve months, this was referred as a safeguarding issue and was dealt with appropriately. A recruitment procedure is in place and the home manager oversees the recruitment process. An application form , two written references, a Criminal Records Bureau Check, and a Protection of Vulnerable adults Check are all undertaken before anyone starts employment. The risk of potential harm to people is reduced as a result of these procedures being implemented. Three staff files were examined and found to be complete and up to date. Discussion with staff showed a good understanding of their role and responsibilities within both the complaints and safeguarding procedures. Evidence: People who use the service experience good quality outcomes in this area. People using the service feel able to air their concerns without fear of repercussions. The staff vetting procedure is sufficiently robust to ensure the safety of the people living in the home. The judgement has been made using available evidence and a visit to this service. Care Homes for Adults (18-65 years) Page 23 of 31 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 who use the service experience good quality outcomes in this area. People living in the home enjoy a clean, safe and homely environment. This judgement has been made using available evidence including a visit to this service. Evidence: A tour of the building was made and the home was found to be clean, overall well maintained and free from odours. The bedrooms of people living in the home were personalised and decorated to suit individual tastes, people spoken with explained how they were involved in choosing colour schemes and soft furnishings for their rooms and other areas of the home. One bedroom was for two people, who when spoken with were happy to share, but did not have any form of privacy screen in place to maintain their privacy and dignity. People had personal belongings and furnishings in their rooms, making them feel homely and reflected the personalities of the occupants. Communal areas were found to be light and airy and there are a choice of sitting areas both within the home and in the garden areas, accessible to the people living in the home. Care Homes for Adults (18-65 years) Page 24 of 31 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 who use the service experience adequate quality outcomes in this area. People living in the home are supported by staff who are overall supervised and attend training. The staff vetting procedure is sufficiently robust to ensure the safety of people living in the home. This judgement has been made using available evidence including a visit to the home. Evidence: Discussion with the manager, staff and examination of the staffing rositer indicates that there are sufficient hours to meet the needs of the people currently living in the home. However, both the manager and senior work over and above their contracted hours to ensure that their management role is fulfilled, which would indicate that additional hours are required within the home to allocate identified time for both parties to fulfil their roles, without compromising the level of care in any way. All newly appointed staff complete an induction within the first six weeks of employment, these are signed off by both the individual and their mentor. Staff continue to receive a range of training courses including: Certificate in safe Handling of Medicines, Handling Medicines in a Social care Setting, Food Hygiene, Dementia Care, COSHH, Fire safety First Aid Appointed Person, Management of Challenging Behaviour, Diabetes care, Moving and Handling. One staff file seen, showed that they had declined to attend further training updates. A recommendation was made in respect of this. All other staff members files seen were up to date with training or had further Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: training sessions booked for this purpose. There has been considerable progress with the NVQ process and each staff member now having completed an National Vocational Qualification at level 2 or 3. 62.5 of the staff team have achieved the award. Staff meetings are held every two months and minutes are signed for after reading, to demonstrate they were aware of any decisions /discussions made in their absence. Supervision is also in place every two months and recorded. At the previous inspection requirements were made in respect of the frequency of both staff meetings and supervision sessions, these are now in place and meet the minimum standard. Care Homes for Adults (18-65 years) Page 26 of 31 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 . People who use this service experience good quality outcome areas in this area. People using the service benefit overall from a safe and well managed home. The judgement has been made using available evidence including a visit to this service. Evidence: Discussion with the registered manager and information in the AQAA has completed the Registered Managers Award. She has several years experience in a senior role working for Prime Life. Information from the Aqaa document stated that fire safety checks, gas and electrical engineering checks are all up to date. Other checks verified included the last portable appliance test, and viewing the certificates for gas and electrical safety checks. risk assessments are in place to cover all areas of the home, including the kitchen and food preparation. fire safety and laundry use. There is a quality assurance system in place for assessing the homes quality of care, which involves surveying people living in the home, relatives, visitors and other professionals.A detailed report is completed from the information collated and areas, in which the home excels or identified areas that need to be improved, are included. Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: Staff are now being supervised regularly both formally and during every day observation. Annual appraisals also take place. Regular residents meetings and staff meetings are in place within the home. Records within the home are stored securely and service users said they were aware that they can see them if they wish. Policies and procedures were found to correspond to the information made available by the home in the Annual Quality Assurance Assessment document. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and emergency lighting checks have been undertaken. Care staff also receive fire training as part of the homes initial training. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 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 6 The registered person should ensure that all care plans have a clear risk assessment for all areas of activity that may be considered a potential risk to the individual. The Registered Provide should consider how some backfill can be provided to enable the manager to have dedicated hours to fulfill her management role within her contracted hours. The Registered Provider should consider how staff who do not attend training can be encouraged to do so. 2 33 3 34 Care Homes for Adults (18-65 years) Page 30 of 31 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). 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